How does vertical reading affect reading speed?

Purpose: Vertical reading is an adaptive reading strategy sometimes used in homonymous hemianopia. This study aimed to measure horizontal and vertical reading speeds in visually normal volunteers using the Radner Reading Chart. Methods: Fifteen orthoptic students, mean age 19.7 years, took part in this repeated measures study. Participants read sentences aloud from the Radner Reading Chart horizontally and rotated vertically, to read up and down the line. Words read correctly and the time taken to read each sentence were recorded. Results: Reading speeds were calculated (words read correctly per second) for horizontal text (2.95 words per second) and for vertical text, reading up the line (1.73 words per second) and reading down the line (1.57 words per second). Reading horizontal text was significantly faster than reading vertical text. Reading horizontal text was 1.22 words per second faster than reading text vertically up (p < 0.0001) and 1.38 words per second faster than text vertically down (p < 0.0001). There was no statistically significant difference between reading text vertically up the line and vertically down the line (0.16 words per second, p = 0.42). Conclusion: Horizontal reading speed, measured with the Radner Reading Chart, was significantly faster than both vertical reading speeds. There was no significant difference between reading vertically up the line and reading vertically down the line. The slower time taken to read the vertically orientated sentences had a greater effect on reading speed than the number of errors made

Surgery to Treat Residual Acquired Excyclotropia without Changing the Primary Position Vertical Deviation: A Case Report

Aim: To describe the surgical management and long-term outcome of a case of symptomatic residual acquired primary position excyclotropia, without changing the primary position vertical deviation. Methods: This case report describes ipsilateral half tendon width transpositions of the left superior rectus temporally and inferior rectus nasally, combined with right inferior rectus posterior fixation suture at 11 mm. Results: Three days postoperatively, the transposition procedure produced a 10° cyclotorsional change in primary position, resulting in 5° of incyclotorsion (double Maddox rod). Six weeks postoperatively, the incyclotorsion regressed to 1° (synoptophore) and a central field of binocular single vision (BSV) (90° horizontally and 60° vertically) was demonstrated without an abnormal head posture. Fifteen months postoperatively, 1° primary position incyclotorsion (Torsionometer) and the central field of BSV remained stable. The primary position vertical deviation was changed by 1 prism diopter and no V pattern was induced. Conclusion: In our case, ipsilateral half tendon width horizontal transpositions of the vertical recti achieved satisfactory correction of excyclotorsion and restored BSV without significantly changing the primary position vertical deviation. The result was stable 15 months postoperatively

A case report of progressive Brown syndrome?

Aim: To report an unusual case of progressive Brown syndrome and the successful surgical treatment. Methods: A 42-year-old male with a documented 14-year history of progressive Brown syndrome is presented. To improve diplopia symptoms an ipsilateral superior oblique (SO) 7 mm silicone tendon spacer and a contralateral 3 mm superior rectus (SR) recession were performed. Results: The surgical procedure was successful in reducing the primary position deviation (preoperative 30ΔLHoT 7ΔLXT; one month post surgery 3ΔLHo; one year post surgery 7-8ΔLHo 1-2ΔE) and eliminating the abnormal head posture (AHP). Diplopia was only reported on elevation and depression following surgery. Conclusion: This case of Brown syndrome is unusual as it was progressive and had a documented history over a number of years prior to surgery. Surgical treatment of Brown syndrome is rarely required, but in this case was successful in improving the patient’s diplopia and AHP

Amblyopia treatment and quality of life: the child's perspective on atropine versus patching

Background: The impact on children of patching versus atropine treatment for amblyopia was assessed using children's perspective Health-Related Quality of Life (HRQoL) scores in 5 to 7-year olds. Methods: Forty-six children on the threshold of commencing either patching or atropine treatment for amblyopia were recruited. Treatment was prescribed for uniocular amblyopia of visual acuity (VA) 0.2 logMAR or worse. After four weeks of their chosen treatment, each child completed the Child Amblyopia Treatment Quality-of-Life Questionnaire (CAT-QoL). The Pediatric Quality of Life Inventory (PedsQL™), Young Child (5-7) Self-Report version, was completed before and after four weeks of treatment. Quality of life scores were compared between the two treatment groups. Results: Sixty-one percent (n = 28) of participants were male and 56.5% (n = 26) were white British. The CAT-QoL has a range of 0-16, with 16 being the worst quality of life. No significant difference was found between the patching group (n = 30, mean age 69.7 months) and the atropine group (n = 16, mean age 69.3 months) for CAT-QoL quality of life scores (Patch median = 6.3, Atropine median = 5.6, U = 199, p = .341, 95% CI of the median difference of -2.3 to 0.9). The Young Child (5-7) Self-Report version of the PedsQL™ has a 'total score' range of 0-100, with 0 being the worst quality of life. There was also no significant difference in PedsQL™ quality of life total scores (Patch median = 80, Atropine median = 83.33, U = 239.5, p = .991, 95% CI of the median difference -13.33 to 10) after four weeks of treatment. Conclusion: Amblyopic children reported that patching and atropine treatments did not have a significant impact on their quality of life. Patching and atropine should continue to be offered as first-line treatments for amblyopia, as children appear to tolerate both well and do not favor one over the other

The provision of patient information about nystagmus

Aims: The aims of this study were to evaluate the current provision of patient information about nystagmus in orthoptic clinics in the UK and Ireland and to develop a standardised information pack about nystagmus. Methods: A questionnaire was circulated to orthoptists in the UK and Ireland asking whether they had information to provide to patients with nystagmus, what was included in this information and how it could be improved. Orthoptists were also asked what should be included in a standardised information pack about nystagmus. Results: Two hundred and thirty three orthoptists completed the questionnaire. One-third of responding orthoptists did not have information to provide to patients with nystagmus. Most reported the information available to them included details of support services and physical symptoms. Including information about living with nystagmus at different ages and long-term prognosis were the most common suggestions to improve information about nystagmus. More than half of orthoptists selected all the suggested topics to be included in a standardised information pack, with support services and long-term prognosis most frequently selected. Conclusions: Only 67% of responding orthoptists had information about nystagmus to give to patients or their families. Ways to improve the current information and content considered important by orthoptists were taken into account to create a nystagmus information pack, which is now available online

Simulation of oscillopsia in virtual reality

Purpose: Nystagmus is characterised by involuntary eye movement. A proportion of those with nystagmus experience the world constantly in motion as their eyes move: a symptom known as oscillopsia. Individuals with oscillopsia can be incapacitated and often feel neglected due to limited treatment options. Effective communication of the condition is challenging and no tools to aid communication exist. This paper describes a virtual reality (VR) application that recreates the effects of oscillopsia, enabling others to appreciate the condition. Methods: Eye tracking data was incorporated into a VR oscillopsia simulator and released as a smartphone app – “Nystagmus Oscillopsia Sim VR”. When a smartphone is used in conjunction with a Google Cardboard headset, it presents an erratic image consistent with oscillopsia. The oscillopsia simulation was appraised by six participants for its representativeness. These individuals have nystagmus and had previously experienced oscillopsia but were not currently symptomatic; they were therefore uniquely placed to judge the app. The participants filled in a questionnaire to record impressions and the usefulness of the app. Results: The published app has been downloaded ~3700 times (28/02/2018) and received positive feedback from the nystagmus community. The validation study questionnaire scored the accuracy of the simulation an average of 7.8/10 while its ability to aid communication received 9.2/10. Conclusion: The evidence indicates that the simulation can effectively recreate the sensation of oscillopsia and facilitate effective communication of the symptoms associated with the condition. This has implications for communication of other visual conditions

Understanding the experiences of post-diagnostic dementia support for South Asians living in England: the need for co-production

© 2023 The authors. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: http://dx.doi.org/10.33140/ijadr.01.01.06Background: The increase in the numbers of South Asians in the United Kingdom (UK) is likely to lead to an increased need for dementia services yet; they are currently under-represented in dementia services. Furthermore, little is known about the prevalence, experience and treatment of dementia in the UK South Asian population, including their experiences of post-diagnostic support. Consequently, a project was commissioned by Alzheimer’s Society in the UK to gather insight into the experiences of post-diagnostic dementia support for the South Asian community in England to identify whether their post-diagnostic support needs were being met and what they needed from post-diagnostic support services. Methodology/Methods: As this project sought to understand experiences, a qualitative case-study approach was adopted. Twelve South Asian carers of a person with dementia and one South Asian person living with dementia took part in an on-line in-depth, topic-guided conversation. All conversations were audio recorded with consent and analysed using a thematic analysis. Findings: Analysis revealed that the South Asian community are doubly affected by dementia in relation to post-diagnostic support because 1) they received very little post-diagnostic support and 2) even when they did, it wasn’t culturally appropriate and therefore ineffective. Essentially, the lack of culturally inclusive care compounds the lack of access further. Consequently, people discussed current gaps in service provision, making recommendations that will result in better support, and more positive experiences for South Asians when diagnosed with dementia in England. In order to achieve this, South Asians in need of dementia support should be involved in the planning, development and delivery of post-diagnostic support services. Conclusions: This paper discusses findings that highlight the importance and benefits of co-production whereby people who use services and carers work with professionals in equal partnerships towards shared goals.This project was funded by Alzheimer’s Society, UK.Published onlin

Revisiting ENSO and IOD Contributions to Australian Precipitation

Tropical modes of variability, such as El Niño–Southern Oscillation (ENSO) and the Indian Ocean Dipole (IOD), exert a strong influence on the interannual variability of Australian precipitation. Nevertheless, commonly used indices of ENSO and IOD variability display significant co-variability that prevents a robust quantification of the independent contribution of each mode to precipitation anomalies. This co-variability issue is often addressed by statistically removing ENSO or IOD variability from the precipitation field before calculating teleconnection patterns. However, by performing a suite of coupled and uncoupled modeling experiments in which either ENSO or IOD variability is physically removed, we show that ENSO-only-driven precipitation patterns computed by statistically removing the IOD influence significantly underestimate the impact of ENSO on Australian precipitation variability. Inspired by this, we propose a conceptual model that allows one to effectively separate the contribution of each mode to Australian precipitation variability

A joint role for forced and internally-driven variability in the decadal modulation of global warming

Despite the observed monotonic increase in greenhouse-gas concentrations, global mean temperature displays important decadal fluctuations typically attributed to both external forcing and internal variability. Here, we provide a robust quantification of the relative contributions of anthropogenic, natural, and internally-driven decadal variability of global mean sea surface temperature (GMSST) by using a unique dataset consisting of 30-member large initial-condition ensembles with five Earth System Models (ESM-LE). We present evidence that a large fraction (~29–53%) of the simulated decadal-scale variance in individual timeseries of GMSST over 1950–2010 is externally forced and largely linked to the representation of volcanic aerosols. Comparison with the future (2010–2070) period suggests that external forcing provides a source of additional decadal-scale variability in the historical period. Given the unpredictable nature of future volcanic aerosol forcing, it is suggested that a large portion of decadal GMSST variability might not be predictable