Photorefraction Screens Millions for Vision Disorders

Who would have thought that stargazing in the 1980s would lead to hundreds of thousands of schoolchildren seeing more clearly today? Collaborating with research ophthalmologists and optometrists, Marshall Space Flight Center scientists Joe Kerr and the late John Richardson adapted optics technology for eye screening methods using a process called photorefraction. Photorefraction consists of delivering a light beam into the eyes where it bends in the ocular media, hits the retina, and then reflects as an image back to a camera. A series of refinements and formal clinical studies followed their highly successful initial tests in the 1980s. Evaluating over 5,000 subjects in field tests, Kerr and Richardson used a camera system prototype with a specifically angled telephoto lens and flash to photograph a subject s eye. They then analyzed the image, the cornea and pupil in particular, for irregular reflective patterns. Early tests of the system with 1,657 Alabama children revealed that, while only 111 failed the traditional chart test, Kerr and Richardson s screening system found 507 abnormalities

Eye Movement Evaluation in Multiple Sclerosis and Parkinson's Disease Using a Standardized Oculomotor and Neuro-Ophthalmic Disorder Assessment (SONDA)

Evaluating the state of the oculomotor system of a patient is one of the fundamental tests done in neuro-ophthalmology. However, up to date, very few quantitative standardized tests of eye movements' quality exist, limiting this assessment to confrontational tests reliant on subjective interpretation. Furthermore, quantitative tests relying on eye movement properties, such as pursuit gain and saccade dynamics are often insufficient to capture the complexity of the underlying disorders and are often (too) long and tiring. In this study, we present SONDA (Standardized Oculomotor and Neurological Disorder Assessment): this test is based on analyzing eye tracking recorded during a short and intuitive continuous tracking task. We tested patients affected by Multiple Sclerosis (MS) and Parkinson's Disease (PD) and find that: (1) the saccadic dynamics of the main sequence alone are not sufficient to separate patients from healthy controls; (2) the combination of spatio-temporal and statistical properties of saccades and saccadic dynamics enables an identification of oculomotor abnormalities in both MS and PD patients. We conclude that SONDA constitutes a powerful screening tool that allows an in-depth evaluation of (deviant) oculomotor behavior in a few minutes of non-invasive testing

Recommended Core Measures for Evaluating the Patient-Centered Medical Home: Cost, Utilization, and Clinical Quality

Outlines the process of the Patient-Centered Medical Home Evaluators' Collaborative for identifying core standardized measures and their recommended principles and measures for evaluating cost and utilization and clinical quality

Glaucoma detection: the content of optometric eye examinations for a presbyopic patient of African racial descent

Aims: Standardised patient (SP) methodology is the gold standard for evaluating clinical practice. We investigated the content of optometric eyecare for an early presbyopic SP of African racial descent, an “at-risk” patient group for primary open-angle glaucoma (POAG). Methods: A trained actor presented unannounced as a 44-year-old patient of African racial descent, complaining of recent near vision difficulties, to 100 community optometrists for an audio-recorded eye examination. The eye examinations were subsequently assessed via a checklist based on evidence-based POAG reviews, clinical guidelines and expert panel opinion. Results: Ninety-five per cent of optometrists carried out optic disc assessment and tonometry, which conforms to the UK College of Optometrists’ advice that those patients aged >40 years should receive at least two of the following tests: tonometry, optic disc assessment, visual field testing. Thirty-five per cent of optometrists carried out all of these tests and 6% advised the SP of increased POAG risk in those of African racial descent. Conclusion: SP encounters are an effective measure of optometric clinical practice. As in other healthcare disciplines, there are substantial differences between optometrists in the depth of their clinical investigations, challenging the concept of a “standard sight test”. There is a need for continuing professional development (CPD) in glaucoma screening, in which the increased risk of POAG in those of African racial descent should be emphasised

Experimental Methods in IIR: The Tension between Rigour and Ethics in Studies Involving Users with Dyslexia

Designing user studies in the interactive information retrieval (IIR) paradigm on people with impairments may sometimes require different methodological considerations than for other users. Consequently, there may be a tension between what the community regards as being a rigorous methodology against what researchers can do ethically with their users. This paper discusses issues to consider when designing IIR studies involving people with dyslexia, such as sampling, informed consent and data collection. The conclusion is that conducting user studies on participants with dyslexia requires special considerations at all stages of the experimental design. The purpose of this paper is to raise awareness and understanding in the research community about experimental methods involving users with dyslexia, and addresses researchers, as well as editors and reviewers. Several of the issues raised do not only apply to people with dyslexia, but have implications when researching other groups, for instance elderly people and users with learning, cognitive, sensory or motor impairments

AI for public health: Self-screening for eye diseases

A software-based visual-field testing (perimetry) system is described which incorporates several AI components, including machine learning, an intelligent user interface and pattern discovery. This system has been successfully used for self-screening in several different public environment