Age Related Visual Pathologies among Nursing Home Residents: An Evaluation of Light Conditions and Recording in Client Files

Objective: Reflection on visual problems in nursing homes. Data Sources: Eye examinations, documented visual problems and illuminance levels. Study design: The optometric examinations and recorded visual problems were combined with illuminance data. Data collection: In seven nursing homes, 259 residents underwent an optometric examination. Their client records were analyzed for information regarding visual functioning. The illuminance data were ranked to set the quality of the lighting conditions. Principal findings: 50% of the referred residents had problems with cataracts, retinal problems (21%), suspected glaucoma (13%), and other pathologies (16%). The information was not current in 56% of the records. The quality of lighting conditions was low or moderate. Conclusion: The finding of poor lighting conditions in nursing homes in combination with a high prevalence of visual problems (with cataract found to be the most common age related pathology), stretches the need of enhanced awareness of eye care by professional caregivers

Outcomes and comorbidities of SCN1A-related seizure disorders

PURPOSE: Differentiating between Dravet syndrome and non-Dravet SCN1A-related phenotypes is important for prognosis regarding epilepsy severity, cognitive development, and comorbidities. When a child is diagnosed with genetic epilepsy with febrile seizures plus (GEFS+) or febrile seizures (FS), accurate prognostic information is essential as well, but detailed information on seizure course, seizure freedom, medication use, and comorbidities is lacking for this milder patient group. In this cross-sectional study, we explore disease characteristics in milder SCN1A-related phenotypes and the nature, occurrence, and relationships of SCN1A-related comorbidities in both patients with Dravet and non-Dravet syndromes. METHODS: A cohort of 164 Dutch participants with SCN1A-related seizures was evaluated, consisting of 116 patients with Dravet syndrome and 48 patients with either GEFS+, febrile seizures plus (FS+), or FS. Clinical data were collected from medical records, semi-structured telephone interviews, and three questionnaires: the Functional Mobility Scale (FMS), the Pediatric Quality of Life Inventory (PedsQL) Measurement Model, and the Child or Adult Behavior Checklists (CBCL/ABCL). RESULTS: Walking disabilities and severe behavioral problems affect 71% and 43% of patients with Dravet syndrome respectively and are almost never present in patients with non-Dravet syndromes. These comorbidities are strongly correlated to lower quality-of-life (QoL) scores. Less severe comorbidities occur in patients with non-Dravet syndromes: learning problems and psychological/behavioral problems are reported for 27% and 38% respectively. The average QoL score of the non-Dravet group was comparable with that of the general population. The majority of patients with non-Dravet syndromes becomes seizure-free after 10 years of age (85%). CONCLUSIONS: Severe behavioral problems and walking disabilities are common in patients with Dravet syndrome and should receive specific attention during clinical management. Although the epilepsy course of patients with non-Dravet syndromes is much more favorable, milder comorbidities frequently occur in this group as well. Our results may be of great value for clinical care and informing newly diagnosed patients and their parents about prognosis

A review of the effects of colour and light on non-image function in humans

This paper reviews current knowledge on non-image-forming aspects of vision. Developments in the last 20 years have included the discovery of a fifth class of human visual pigment (melanopsin), in addition to the three classes of photopsin to be found in the cones and rhodopsin in the rods in the human retina. Melanopsin is found in a small number of retinal ganglion cells which then, in addition to receiving input from rods and cones, are intrinsically photosensitive. These retinal ganglion cells send their input primarily to the hypothalamus, where they help to regulate the circadian system (daily rhythms of sleep patterns, body temperature, heart rate, etc.). The discovery of the anatomical basis of non-image-forming vision has led to a great deal of research into the effects of light on sleep, depression and mood, retinal photodamage and well-being, amongst other factors. Given that recent technological innovations in LED lighting now give us greater control over environmental lighting, it is timely to review the non-visual effects of light in humans in order to inform lighting design in the future

Ouderen en oogzorg

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Omgaan met visuele beperkingen in het verpleeghuis

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Evidence Based Practice: basisbegrippen onderzoek en kritisch lezen

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