low vision

低视力
  • 文章类型: Journal Article
    背景。在整个生命周期中,低视力和失明的患病率意味着职业治疗师将在所有实践领域遇到这些情况。从业者必须具备识别和应对视力丧失相关问题所必需的能力。目的。这项研究旨在确定为低视力和失明患者提供服务时必不可少的职业治疗能力。方法。该研究采用了通过在线调查和焦点小组管理的三阶段改进的Delphi方法。受访者包括低视力或失明的人,在低视力/失明方面具有特殊专业知识的专业人员,和其他实践领域的职业治疗师。使用迭代方法分析数据,涉及能力定量分析的共识生成策略,定性输入,和专家小组审查。调查结果。该过程产生了一个分为六个领域的51项能力框架。含义。该框架为加拿大职业治疗计划的共同课程和创建教育资源奠定了基础。
    Background. The prevalence of low vision and blindness in persons across the lifespan means that occupational therapists will encounter these conditions across all areas of practice. Practitioners must be equipped with competencies necessary to recognize and respond to vision loss-related concerns. Purpose. This study sought to identify essential occupational therapy competencies when providing services to people with low vision and blindness. Method. The study employed a three-phase modified Delphi methodology administered through online surveys and focus group. Respondents included people with low vision or blindness, professionals with special expertise in low vision/blindness, and occupational therapists in other practice areas. Data were analyzed using an iterative, consensus-generating strategy involving quantitative analysis of competencies, qualitative input, and expert panel review. Findings. The process yielded a 51-item competency framework organized into six domains. Implications. The framework provides the foundation for a common curriculum for Canadian occupational therapy programs and for the creation of educational resources.
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  • 文章类型: Journal Article
    背景:与视觉功能相关的生活质量是一个多维结构,可补充低视力患者的功能评估。它显示了个人在价值体系和社会文化背景下对眼部疾病及其治疗过程的看法。这种临床流行病学结果被认为是客观和有价值的。
    方法:进行了内容验证研究,其中涉及翻译和回译量表以评估语义,惯用的,概念性的,和结果版本中的经验对等。这项研究包括21个人的参与,并使用Aiken'sV系数进行定量评估,以分析在相关性和经验能力类别中分配的分数。
    结果:重新组织问卷。这些例子被扩大了,并提到了一些光学辅助装置。此外,术语被改变以提高理解和减少粗鲁。在25个项目中,11的AikenV系数小于1.0。
    结论:获得的版本与原始问卷相当。然而,针对本地上下文的惯用曲折强调了内容验证的必要性,以确保正确的解释并有助于规模的更新。
    BACKGROUND: The quality of life related to visual function is a multidimensional construct that complements the functional assessment of patients with low vision. It shows the individual\'s perception of the course of ocular disease and its treatment within the framework of a value system and a sociocultural context. This clinical-epidemiological outcome is recognized as objective and valuable.
    METHODS: A content validation study was conducted, which involved translating and back-translating the scale to evaluate semantic, idiomatic, conceptual, and experiential equivalence in the resulting version. The study included the participation of 21 individuals, and a quantitative evaluation was performed using Aiken\'s V coefficient to analyze the scores assigned in the categories of relevance and experiential capacity.
    RESULTS: The questionnaire presentation was reorganized. The examples were expanded, and some optical aids were mentioned. Additionally, terms were changed to improve comprehension and reduce rudeness. Out of the 25 items, 11 had an Aiken V coefficient of less than 1.0.
    CONCLUSIONS: The obtained version is comparable to the original questionnaire. However, the idiomatic twists specific to the local context emphasize the need for content validation to ensure correct interpretation and contribute to the updating of the scale.
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  • 文章类型: Journal Article
    暂无摘要。
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  • 文章类型: Journal Article
    Bardet-Biedl综合征是一种罕见的常染色体隐性遗传病,具有异质性临床表现。本研究报告了一个14岁女孩和她的6岁姐姐的BBS2基因的新型复合杂合基因型的临床特征,这些女孩抱怨早发性低视力。眼底图像显示视网膜色素变性样变化,和全场视网膜电图显示两名患者的杆或锥反应没有幅度。有趣的是,在姐姐身上观察到眼球震颤。在体检时,姐妹们有中度肥胖,没有多指,性腺功能减退,或智力残疾。外显子组测序揭示了姐妹中BBS2的一种新的复合杂合基因型,即父系遗传的NM_031885.5:c.5341G>T变体和母系遗传的NM_031885.5:c.700C>T(p。Arg234Ter)变体。根据美国医学遗传学和基因组学学会指南,这两种变体都被归类为致病性。这项研究为BBS2基因的基因型-表型关系提供了有用的信息,用于遗传咨询和诊断。
    Bardet-Biedl syndrome is a rare autosomal recessive genetic disorder with heterogenous clinical manifestations. The present study reports the clinical features of a novel compound heterozygous genotype of the BBS2 gene in a 14-year-old girl and her 6-year-old sister who had complaints of early-onset low vision. Fundus images revealed retinitis pigmentosa-like changes, and full-field electroretinograms showed no amplitude for the rod or cone response in both patients. Interestingly, nystagmus was observed in the older sister. On physical examination, the sisters had moderate obesity without polydactyly, hypogonadism, or intellectual disability. Exome sequencing revealed a novel compound heterozygous genotype of BBS2 in the sisters, namely the paternally inherited NM_031885.5:c.534 + 1G > T variant and the maternally inherited NM_031885.5:c.700C > T (p.Arg234Ter) variant. Both variants were classified as pathogenic according to the American College of Medical Genetics and Genomics guidelines. This study provides useful information on the genotype-phenotype relationships of the BBS2 gene for genetic counseling and diagnosis.
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  • 文章类型: Journal Article
    我们设计了一种新颖的“Point-and-Tap”界面,使盲人或视障人士(BVI)能够轻松获取有关触觉图形和3D模型的多个级别的信息。该界面使用iPhone的深度和彩色摄像头来跟踪用户的手,同时他们与模型交互。当用户用食指指向模型上感兴趣的特征时,系统朗读有关该功能的基本信息。有关其他信息,用户抬起食指并再次点击该功能。这个过程可以重复多次,以访问其他级别的信息。例如,在触觉地图中的区域上点击一次可以触发该区域的名称,随后的水龙头吸引了人口,area,气候,等。除非用户做出指向手势,否则不会触发音频标签,这允许用户用一只手或双手自由地探索模型。多次点击可用于快速跳过信息级别,每个水龙头都会中断当前的话语。这允许用户比按顺序收听所有级别更快地达到所需的信息级别。对六名BVI参与者的实验表明,该方法是可行的,易于学习和有效。
    We have devised a novel \"Point-and-Tap\" interface that enables people who are blind or visually impaired (BVI) to easily acquire multiple levels of information about tactile graphics and 3D models. The interface uses an iPhone\'s depth and color cameras to track the user\'s hands while they interact with a model. When the user points to a feature of interest on the model with their index finger, the system reads aloud basic information about that feature. For additional information, the user lifts their index finger and taps the feature again. This process can be repeated multiple times to access additional levels of information. For instance, tapping once on a region in a tactile map could trigger the name of the region, with subsequent taps eliciting the population, area, climate, etc. No audio labels are triggered unless the user makes a pointing gesture, which allows the user to explore the model freely with one or both hands. Multiple taps can be used to skip through information levels quickly, with each tap interrupting the current utterance. This allows users to reach the desired level of information more quickly than listening to all levels in sequence. Experiments with six BVI participants demonstrate that the approach is practical, easy to learn and effective.
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  • 文章类型: Journal Article
    背景:严重疲劳是视力障碍患者的常见症状,对情绪功能有不利影响,认知,工作能力和日常生活活动。先前的一项研究发现,抑郁是疲劳的最重要决定因素之一,但对该患者人群中疾病特异性因素的了解较少。本研究旨在探讨低视力成人视力障碍严重程度与疲劳的关系。直接和间接,视特异性因素和抑郁作为潜在的中介。
    方法:通过电话访谈收集了220名荷兰低视力服务患者的横断面数据。疲劳被定义为根据严重程度和对日常生活的影响的潜在变量。潜在的介质包括视觉相关症状,适应视力丧失和抑郁。在Mplus中构建了假设的结构方程模型,以测试(in)视觉障碍严重程度的直接影响(轻度/中度,严重,失明)通过上述变量对疲劳的影响。
    结果:最终模型解释了60%的疲劳变化,并揭示了视觉障碍严重程度对疲劳的显着总影响。与轻度/中度视力障碍患者(β=-0.50,95%偏差校正置信区间[BCCI][-0.86,-0.16])和失明患者(β=-0.44,95%BCCI[-0.80,-0.07])相比,重度视力障碍患者(参照组)的疲劳症状明显更高。眼睛疲劳和光干扰,抑郁症和与视觉相关的移动性介导了重度和轻度/中度视觉障碍类别之间的疲劳差异。严重视力障碍和失明类别之间的疲劳差异仅由眼睛疲劳和光干扰来解释。此外,抑郁症状(β=0.65,p<0.001)和眼睛疲劳和光障碍(β=0.19,p=0.023)与疲劳直接相关,而与视觉障碍的严重程度无关。
    结论:我们的研究结果表明,低视力患者的视觉障碍严重程度与疲劳之间存在倒U形关系。这种关系的复杂性可能是由视觉障碍的后果来解释的,特别是紧张的眼睛和抑郁的情绪,而不是残疾本身的严重程度。
    BACKGROUND: Severe fatigue is a common symptom for people with visual impairment, with a detrimental effect on emotional functioning, cognition, work capacity and activities of daily living. A previous study found that depression was one of the most important determinants of fatigue, but less is known about disease-specific factors in this patient population. This study aimed to explore the association between visual impairment severity and fatigue in adults with low vision, both directly and indirectly, with vision-specific factors and depression as potential mediators.
    METHODS: Cross-sectional data were collected from 220 Dutch low vision service patients by telephone interviews. Fatigue was defined as a latent variable by severity and impact on daily life. Potential mediators included vision-related symptoms, adaptation to vision loss and depression. Hypothesized structural equation models were constructed in Mplus to test (in)direct effects of visual impairment severity (mild/moderate, severe, blindness) on fatigue through above mentioned variables.
    RESULTS: The final model explained 60% of fatigue variance and revealed a significant total effect of visual impairment severity on fatigue. Patients with severe visual impairment (reference group) had significantly higher fatigue symptoms compared to those with mild/moderate visual impairment (β = -0.50, 95% bias-corrected confidence interval [BC CI] [-0.86, -0.16]) and those with blindness (β = -0.44, 95% BC CI [-0.80, -0.07]). Eye strain & light disturbance, depression and vision-related mobility mediated the fatigue difference between the severe and mild/moderate visual impairment categories. The fatigue difference between the severe visual impairment and blindness categories was solely explained by eye strain & light disturbance. Moreover, depressive symptoms (β = 0.65, p < 0.001) and eye strain & light disturbance (β = 0.19, p = 0.023) were directly associated with fatigue independent of visual impairment severity.
    CONCLUSIONS: Our findings indicate an inverted-U shaped relationship between visual impairment severity and fatigue in patients with low vision. The complexity of this relationship is likely explained by the consequences of visual impairment, in particular by strained eyes and depressive mood, rather than by severity of the disability itself.
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  • 文章类型: Journal Article
    评估在晚期干性AMD患者中植入小切口新一代植入式微型望远镜(SINGIMT)的可行性和结果。
    5例患有稳定干性AMD的假晶状体患者眼适合于SINGIMT植入。由于先前的YAG激光囊切开术,排除了四只眼睛。患者接受术前评估,包括视力测量和OCT扫描。
    在球周麻醉下进行外科手术,仔细去除IOL和SINGIMT植入。术后定期随访以监测视力,设备定位和并发症。
    术后结果显示,大多数患者的视力改善,CDVA(校正远距视力)和CNVA(校正近视力)平均增加16,8±10,2和13,8±7,4个ETDRS字母,分别。已观察到有限的并发症。在一个案例中,我们观察到装置错位进入玻璃体腔,我们通过玻璃体切除术和使用GoreTex缝线对SINGIMT进行巩膜固定来管理。
    尽管传统上对假晶状体患者禁用,选定病例的SINGIMT植入产生了良好的结果,这表明了这一人群的潜在利益。需要进一步研究更大的样本量和更长的随访期,以完善患者选择标准并优化手术技术。
    UNASSIGNED: To evaluate the feasibility and outcomes of implanting the Smaller-Incision New-Generation Implantable Miniature Telescope (SING IMT) in pseudophakic patients affected by late-stage dry AMD.
    UNASSIGNED: Five pseudophakic patients\' eyes with stable dry AMD were suitable for SING IMT implantation. Four eyes were excluded because of previous YAG laser capsulotomy. Patients underwent preoperative assessments, including visual acuity measurements and OCT scans.
    UNASSIGNED: Surgical procedures were performed under peribulbar anesthesia, with careful IOL removal and SING IMT implantation. Postoperative follow-up was conducted at regular intervals to monitor visual acuity, device positioning and complications.
    UNASSIGNED: Postoperative outcomes demonstrated improvements in visual acuity for most patients with an average gain in CDVA (Corrected Distance Visual Acuity) and CNVA (Corrected Near Visual Acuity) of 16,8 ± 10,2 and 13,8 ± 7,4 ETDRS letters, respectively. Limited complications have been observed. In one case, we observed dislocation of the device into the vitreous chamber, which we managed through vitrectomy and scleral fixation of the SING IMT using GoreTex suture.
    UNASSIGNED: Despite being traditionally contraindicated for pseudophakic patients, SING IMT implantation in selected cases yielded favorable outcomes, indicating potential benefits for this population. Further research with larger sample sizes and longer follow-up periods is warranted to refine patient selection criteria and optimize surgical techniques.
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  • 文章类型: Journal Article
    简介青光眼是一种慢性疾病,可导致严重的视力障碍和失明。方法纳入91例年龄60岁及以上的原发性开角型青光眼患者(第1组)和83例年龄和性别分布相似的健康对照者(第2组)。疾病的持续时间,每天使用的抗青光眼滴剂的数量,并记录视野参数。然后,所有参与者都接受了精神科医生的全面精神状态检查,并接受了老年抑郁量表(GDS)。结果在第1组中,青光眼的平均持续时间为10.2±6.0年,每天使用的平均滴数为2.91±1.47滴/天。根据视野(24-2)数据,平均平均偏差(MD)为-7.76±4.78dB,平均模式标准偏差(PSD)为5.14±2.60dB.根据MD的分类,33例(36.3%)患者处于早期阶段,中间阶段36(39.5%),和22(24.2%)在高级阶段。组1的平均最佳矫正视力(BCVA)为0.85±0.38logMAR,组2为0.34±0.19logMAR。第1组平均GDS评分为13.7±7.23分,第2组平均GDS评分为3.61±1.71分。在BCVA和GDS评分方面,两组之间存在统计学上的显着差异(分别为p=0.039和p<0.001)。结论总之,重要的是,眼科医生提供有关青光眼的充分信息,以防止青光眼患者出现抑郁症。这些信息可以保护患者免受不确定性的影响。青光眼管理的多学科方法,一种威胁视力的慢性疾病,可以积极影响患者对随访和治疗的依从性,提高医疗质量,改善治疗反应。
    Introduction Glaucoma is a chronic disease that can lead to severe visual impairment and blindness. Methods The study included 91 primary open-angle glaucoma patients aged 60 years and older (group 1) and 83 healthy controls (group 2) with similar age and gender distribution. The duration of the disease, the number of anti-glaucomatous drops used daily, and visual field parameters were recorded. All participants then underwent a comprehensive mental status examination by a psychiatrist and were administered the Geriatric Depression Scale (GDS). Results In Group 1, the mean duration of glaucoma was 10.2±6.0 years, and the mean number of drops used per day was 2.91±1.47 drops/day. According to visual field (24-2) data, the mean mean deviation (MD) was -7.76±4.78 dB and the mean pattern standard deviation (PSD) was 5.14±2.60 dB. According to the classification based on MD, 33 (36.3%) patients were in the early stage, 36 (39.5%) in the intermediate stage, and 22 (24.2%) in the advanced stage. The mean best-corrected visual acuity (BCVA) was 0.85±0.38 logMAR in group 1 and 0.34±0.19 logMAR in group 2. The mean GDS scores were 13.7±7.23 points in group 1 and 3.61±1.71 points in group 2. There were statistically significant differences between the groups in terms of BCVA and GDS scores (p=0.039 and p<0.001, respectively). Conclusion In conclusion, it is important that ophthalmologists provide adequate information about glaucoma to prevent the development of depression in patients with glaucoma. This information may protect patients from uncertainty. A multidisciplinary approach in the management of glaucoma, a chronic and vision-threatening disease, can positively affect patients\' compliance with follow-up and treatment, increase the quality of healthcare, and improve treatment responses.
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  • 文章类型: Journal Article
    个人智能技术正日益融入日常生活,然而,这些现成技术对残疾人的可用性和有用性尚未确定。具有本地和可下载功能(技能)的智能扬声器具有通过通信功能为残疾人提供支持的巨大潜力,智能家居集成,还有更多.然而,有用性的潜力并不总是转化为在现实世界中如何实际感知或使用某些东西。因此,这项定性研究的目的是收集残疾人对智能音箱和智能音箱技能体验的洞察力。参与者的反馈强调了几个主要主题:(1)可能影响范围的外部因素,以及智能音箱使用的进步,(2)智能音箱使用障碍,(3)智能扬声器使用促进者,和(4)特定于残疾人的智能扬声器用途。需要继续进行研究和开发,以帮助确保商业上可用的技术采用通用设计原则设计,以确保所有潜在用户的可访问性。
    智能扬声器技能正在被残疾人用于智能家居管理,但是这些功能并非没有障碍。各种残疾人应参与智能扬声器功能的开发和翻译,旨在,或者可能,满足这些人口的需求。
    Personal smart technologies are becoming increasingly interwoven into everyday life, yet the usability and usefulness for some of these off-the-shelf technologies for persons with disabilities has yet to be determined. Smart speakers with both their native and downloadable functionalities (skills) have great potential to support individuals with disabilities through communication functionalities, smart home integrations, and more. However, the potential for usefulness does not always translate to how something is actually perceived or used in the real-world. Therefore, the objective of this qualitative study was to gather insight from individuals with disabilities on their experiences with smart speakers and smart speaker skills. Participant feedback highlighted several primary themes: (1) external factors that might influence extent of, and advancement in smart speaker use, (2) Smart speaker use barriers, (3) Smart speaker use facilitators, and (4) Smart speaker uses specific to individuals with disabilities. Continued research and development is needed to help ensure that commercially available technologies are designed with universal design principles that will ensure accessibility for all potential users.
    Smart speaker skills are being used for smart home management by persons with disabilities, but these functionalities are not without barriers.Persons with various disabilities should be involved in the development and translation of smart speaker functions that are intended to, or that could, support the needs of this population.
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  • 文章类型: Journal Article
    我们确定了新接受视力康复服务的患者的非处方放大镜使用率,并试图阐明患者的非处方放大镜评级是否与视力康复管理策略相关。
    对2021-2023年间看到的274名新的视力康复患者的回顾性记录审查是由三家眼科学术中心的验光提供者完成的。验光学院,私人实践。
    超过一半(58%)的患者尝试使用非处方放大镜。年龄较大与尝试非处方放大镜显著相关(OR:1.04;p<0.001)。尝试使用非处方放大镜的患者,提供者推荐和/或分配规定的手持式光学照明放大镜(P<=0.04)或推荐CCTV电子放大镜(P=0.049)的可能性更大。大多数表明非处方放大镜有些(46%)或没有帮助(38%)。当提供商随后推荐闭路电视(OR:4.8;p=0.01)或更高的基于眼镜的近增加功率(OR:2.0;p=0.02)时,将非处方放大镜评级为无帮助的可能性要大得多。
    由于大多数新患者对非处方放大镜不满意,令人鼓舞的是,以前的非处方放大镜使用经常导致视力康复提供者规定的手持式光学照明放大镜的升级,或将患者过渡到CCTV电子放大镜或基于眼镜的高附加功率以进行近阅读。这些发现支持,以前经历过非处方药放大镜有帮助或没有帮助的老年人是接受验光提供者视力康复的理想候选人,他们可以将他们过渡到规定的放大设备,以更好地支持他们的视觉功能需求。
    只有一小部分新寻求视力康复服务的视力受损患者认为非处方放大镜有帮助;但他们还有其他可行的选择,由于验光视力康复提供者规定了替代放大装置,例如基于眼镜的高近增加功率或为患者提供电子视觉辅助。通常建议以前尝试过非处方放大镜的患者,并从视力康复提供者那里接受不同的放大设备,应鼓励他们在办公室评估其他辅助设备,以确定它们是否更可接受和/或更适合满足患者的需求。对于尚未进行视力康复的患者及其家属,我们的研究结果表明,他们不应该放弃放大镜,并保持开放的可能性,使用其他类型的放大可能是有益的,比如不同的光学放大镜,强近老花镜的处方,电子视频放大,或智能手机或平板电脑的视觉辅助应用程序。
    UNASSIGNED: We determined over-the-counter magnifier usage rates by patients who newly presented for vision rehabilitation services, and sought to elucidate whether patients\' ratings of over-the-counter magnifiers were associated with vision rehabilitation management strategies.
    UNASSIGNED: Retrospective records reviews of 274 new vision rehabilitation patients seen between 2021-2023 were completed by three optometric providers at an ophthalmic academic center, college of optometry, and private practice.
    UNASSIGNED: Over half (58%) of patients tried an over-the-counter magnifier. Older age was significantly associated with trying over-the-counter magnifiers (OR:1.04; p < 0.001). Patients who tried an over-the-counter magnifier had significantly greater odds of the provider recommending and/or dispensing a prescribed hand-held optical illuminated magnifier (P< =0.04) or recommending a CCTV electronic magnifier (p = 0.049). The majority indicated over-the-counter magnifiers were somewhat (46%) or not helpful (38%). There was a significantly greater odds of rating the over-the-counter magnifier as not helpful when the provider subsequently recommended a CCTV (OR:4.8; p = 0.01) or higher spectacle-based near add power (OR: 2.0; p = 0.02).
    UNASSIGNED: Since most new patients were unsatisfied with over-the-counter magnifiers, it is encouraging that previous over-the-counter magnifier use often led to upgrades with hand-held optical illuminated magnifiers prescribed by vision rehabilitation providers, or patients were transitioned to CCTV electronic magnifiers or spectacle-based high add powers for near reading. These findings support that older adults who have previously experienced that over-the-counter magnifiers were either helpful or unhelpful are ideal candidates to receive vision rehabilitation by optometric providers who can transition them to a prescribed magnification device to better support their visual functioning needs for near reading.
    Over-the-counter magnifiers were deemed helpful by only a small proportion of visually-impaired patients who were newly seeking vision rehabilitation services; but there other are viable options for them, since optometric vision rehabilitation providers prescribed alternative magnification devices, such as spectacle-based high near add powers or electronic visual aids for patients.Patients who have previously tried an over-the-counter magnifier were often recommended and received a different magnification device from vision rehabilitation providers who should be encouraged to evaluate other aids in-office to determine if they are more acceptable and/or better suited to meet patients’ needs.For patients and their families who have not yet pursued vision rehabilitation, our findings indicate that they should not give up on magnifiers and remain open to the possibility of using other types of magnification that could be helpful, such as a different optical magnifier, prescription for strong near reading glasses, electronic video magnification, or visual assistive apps for smartphones or tablets.
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