Contrast sensitivity and visual disability in chronic simple glaucoma.

A battery of vision tests was used to quantify visual defect in a group of 50 patients with chronic simple glaucoma. The vision tests were near and distance visual acuity, visual fields, and contrast sensitivity to static and temporally modulated sinusoidal grating patterns. Of these, static contrast sensitivity function appears to be the most sensitive method of measuring visual defect in glaucoma patients. The visual disability experienced by the glaucoma patients was quantified by means of a questionnaire, and the relationship between perceived visual disability and visual defect was examined. It was found that results from a group of tests, near visual acuity, visual field, and contrast sensitivity measures, are the best predictors of the difficulty experienced by patients in performing visually dependent daily activities.     

百分格法定量分析视野缺损

对50名视野缺损患者，在相同条件下间隔一小时用双盲法由两名医院分别行视野检查，然后用Esterman氏法定量分析视野缺损，通过定量对比发现大部分患者者后两次视野检查结果存在差异，未超10个格子者应认为是“可允许的波动”。     

The effect of regression towards the mean on visual disability rating scales

The effects of regression towards the mean on visual disability rating scales are analyzed. Some current strategies underestimate true visual disability by approximately 20% because they selectively retest missed points. This error does not occur if single pass or global retesting is utilized. Global retesting is a cost effective method of minimizing this problem and decreasing test variance.Statistical evaluation of the data was performed by R. Kryscio, Ph.D., Department of Statistics, University of Kentucky.     

Visual disability among patients attending glaucoma clinic in a tertiary hospital

International Ophthalmology - To report visual impairment and blindness among the patients attending a glaucoma clinic in a tertiary university hospital and highlight the possible...     

青光眼术后滤过泡功能障碍及其治疗的临床探讨

目的探讨青光眼滤过术后滤过泡功能障碍及其治疗。方法对2002年1月至2003年12月我院青光眼滤过手术67例（89眼）进行回顾性分析。结果术后滤过泡功能障碍14例14眼，其中渗漏性滤过泡1眼，滤过泡瘢痕4眼，包裹性滤过泡9眼。此14眼经及时进行药物治疗、眼球按摩及球结膜粘连分离等治疗均使眼压控制在正常水平。结论青光眼术后滤过泡功能障碍及时正确治疗，可提高手术成功率，避免严重并发症。     

Visual function,disability, and psychological impact of glaucoma

PURPOSE OF REVIEW: This report briefly reviews recent instruments designed to test the visual function and quality of life of patients with glaucoma. RECENT FINDINGS: Several investigators have examined the functional status and vision-related quality of life among patients with glaucoma. These studies have shown that patients with glaucoma experience diminished visual function and poorer quality of life. SUMMARY: Because glaucoma and its treatment, either medical or surgical, can affect global quality of life as well as vision-related functioning, the assessment of both general and visual system health status is relevant.     

The relationship between visual disability and visual field in patients with glaucoma

PURPOSE: To evaluate the relationship between visual disability and the remaining visual field in glaucoma patients. DESIGN: Prospective noncomparative survey. PARTICIPANTS: One hundred forty-seven Japanese patients with glaucoma were examined. METHODS: Using a previously developed questionnaire, we assessed the relationship between visual disability indices and both the visual field examined using program 30-2 of the Humphrey Field Analyzer and visual acuity. MAIN OUTCOME MEASURES: Pearson's correlation coefficients between visual disability indices and the 22 visual field and 2 visual acuity measurements were calculated. Multiple regression analysis with stepwise variable selection identified factors significantly contributing to visual disability. RESULTS: We identified a significant correlation between visual disability and both the visual field and visual acuity measurements collected. Of the factors examined, retinal sensitivity in the lower hemifield within 5 degrees of the fixation and visual acuity in the better eye significantly contributed to all the item and total disability indices (DIs), measurements of the degree of visual disability as evaluated by the questionnaire; visual acuity in the worse eye contributed to two of the seven item DIs, as well as the total DI. The R value for total DI (R = 0.87, P < 0.0001) indicated that approximately 76% of the visual disability could be explained by these factors. CONCLUSIONS: The Japanese glaucoma patients' visual disability is explained primarily by retinal sensitivity in the lower hemifield within 5 degrees of the fixation and visual acuity in the better eye and secondarily by visual acuity in the worse eye.     

半导体激光治疗重症青光眼--睫状体光凝和睫状体冷冻的对比研究

６０例（６０只眼）重症青光眼患者，随机分成半导体激光经巩膜睫状体光凝组和睫状体冷冻组。半导体激光功率１．５～２．０Ｗ、脉冲时间２ｓ、治疗范围２７０°，发射１２～２０个激光点。所有病例均完成３个月的随访观察，结果与冷冻组比较，光凝组治疗成功率为７３．３％，疼痛解除率为９６．７％，Ｐ＞０．０５；光凝组治疗后１天及１周的眼压分别为２２．１０±９．３４ｍｍＨｇ和１８．１３±６．４０ｍｍＨｇ，Ｐ＜０．０１；末次随访时光凝组眼压２０．５４±７．９６ｍｍＨｇ，Ｐ＞０．０５。光凝组早期并发症少，Ｐ＜０．０１。半导体激光经巩膜睫状体光凝与传统的睫状体冷冻比较，具有简便、安全、降压快、副作用小、疗效可靠等优点，是治疗难治性青光眼的有效手段之一。     

How to intubate the eye in severe glaucoma?

A new approach for the treatment of serious and/or uncurable glaucoma is proposed by the adjonction of a drain, cut in a crinotube, with micro-perforations and set in the classical opening of a trabeculectomy. In four years, for nine cases of particularly severe hypertonia, we observed one relative unsuccess, three real and stable improvements during two years and then with the necessity of local treatment (for rather young patients), and five clear and till today durable improvements. We have also observed a very good local tolerance for all cases, with never a persisting major hypotonia. This simple and efficient process seams susceptible to find its room in the treatment of severe hypertonia.     

Incidence and prevalence of glaucoma in severe ocular surface disease

PURPOSE: To describe the incidence and prevalence of glaucoma in a patient population with severe ocular surface disease (OSD). METHODS: A retrospective case series was compiled from all charts of patients in the Cincinnati Eye Institute/University of Cincinnati and University of Minnesota population with a diagnosis of severe OSD from 1991 to 2003. The incidence and prevalence of glaucoma in the overall patient population were identified, and stratified into disease subgroups. RESULTS: Of the 108 eyes evaluated in this study, 71 were diagnosed with glaucoma. The overall prevalence of glaucoma in patients with severe OSD is 65.7%, with a range from 42.9% to 88.4%. Analysis by subgroup shows the highest percentage of patients with concurrent glaucoma fall into the categories of aniridia and chemical injury, and the lowest was noted in those patients with autoimmune or iatrogenic OSD. Overall, the incidence of glaucoma was 20.4%, with a range of 13.6% to 60%. CONCLUSIONS: Compared with previous studies, our results show a significantly higher prevalence of glaucoma in patients with severe OSD. This information warrants increased attention to treatment and management of OSD and concurrent glaucoma.     

Effect of a resutured iridotomy on glare disability in glaucoma patients having cataract surgery

Twenty-two glaucoma patients with fixed miotic pupils prior to cataract surgery were retrospectively divided into two groups: Group A in which the sector iridotomy was resutured after intraocular lens insertion; Group B in which the sector iridotomy was not resutured. The two groups were matched for average age, sex, average disease duration, glaucoma type, operation type, mean follow-up, and average intraocular pressure and cup/disc ratio. Glare disability was measured with the Miller-Nadler tester. A similar reduction in visual acuity under glare was found in the two groups: 0.55 + 1.2 and 0.45 + 0.9 Snellen lines for Groups A and B, respectively. These findings are explained by two additional observations: Reduction in visual acuity under glare was positively correlated to the degree of posterior capsule opacity (r=0.4) and not to the functional pupillary area (r=0.13). Functional pupillary area (upper lid in normal position) was 42% larger in the nonresutured group compared to 85% difference in the total pupillary area.     

Endolaser treatment of the ciliary body for severe glaucoma

Endolaser photocoagulation of the ciliary body was used to treat 42 eyes with severe glaucoma that could not be managed successfully by medical therapy and conventional glaucoma surgery. Follow-up ranged from 6 to 36 months (mean, 13 months). The preoperative intraocular pressure (IOP) ranged from 13 to 76 mmHg (mean, 37 mmHg). The postoperative IOP ranged from 1 to 44 mmHg (mean, 17 mmHg), representing an absolute decrease of 20 mmHg, and a mean decrease of 48%. After one or two (7 eyes) treatment sessions, 11 eyes (26%) had an IOP less than 21 mmHg without medications; 21 eyes (50%) had an IOP less than 21 mmHg with medications; 5 eyes (12%) had an IOP of 21 to 25 mmHg with or without medications; and 5 eyes (12%) had an IOP greater than 25 mmHg. Postoperatively, the number of antiglaucoma medications required was reduced from a mean of 2.8 +/- 0.13 to a mean of 1.4 +/- 0.19. Twenty-three (72%) of 32 patients were able to discontinue carbonic anhydrase inhibitors.