The Contact Lens Impact on Quality of Life (CLIQ) questionnaire: development and validation

NoPURPOSE. To develop and validate a questionnaire for the measurement of the impact of contact lenses on quality of life (QoL): The Contact Lens Impact on Quality of Life (CLIQ) Questionnaire. METHODS. The questionnaire was developed and validated using conventional methods and Rasch analysis to assure content validity, repeatability, construct validity, and low respondent burden. Item identification and selection (647 items) were performed with an extensive literature review, professional advice, and lay focus groups. Item reduction used focus groups and data obtained from 161 subjects completing a 90-item pilot questionnaire. Validity and reliability, from data of 128 additional subjects, were assessed using Rasch analysis, intraclass correlation coefficient, and Bland-Altman limits of agreement. RESULTS. A 28-item CLIQ Questionnaire was developed and shown to have good validity and reliability by Rasch analysis statistics: real person separation, 2.02; model person separation, 2.17; reliability, 0.80; root mean square measurement error, 2.73; mean square ± SD infit, 1.01 ± 0.18; outfit, 1.01 ± 0.19. The items (mean score, 49.8 ± 4.9) were well targeted to the subjects (mean score, 51.2 ± 6.2) with a mean difference of 1.35 (scale range, 0-100) units. Test-retest intraclass correlation coefficient (0.86) and coefficient of repeatability (±8.00 units) demonstrated good repeatability. CONCLUSIONS. Rasch analysis and standard psychometric analyses demonstrated that the 28-item CLIQ Questionnaire is a valid and reliable measure of QoL in contact lens wearers. A scoring algorithm is provided for CLIQ Questionnaire users to convert raw scores into the Rasch analysis-derived linear person measures

An evaluation of the Amblyopia and Strabismus Questionnaire using Rasch analysis

noPURPOSE. To evaluate whether the Amblyopia and Strabismus Questionnaire (A&SQ) is a suitable instrument for the assessment of vision-related quality-of life (VR-QoL) in individuals with strabismus and/or amblyopia. METHODS. The A&SQ was completed by 102 individuals, all of whom had amblyopia, strabismus, or both. Rasch analysis was used to evaluate the usefulness of individual questionnaire items (i.e., questions); the response-scale performance; how well the items targeted VR-QoL; whether individual items showed response bias, depending on factors such as whether strabismus was present; and dimensionality. RESULTS. Items relating to concerns about the appearance of the eyes were applicable only to those with strabismus, and many items showed large ceiling effects. The response scale showed disordered responses and underused response options, which improved after the number of response options was reduced from five to three. This change improved the discriminative ability of the questionnaire (person separation index increased from 1.98 to 2.11). Significant bias was found between strabismic and nonstrabismic respondents. Separate Rasch analyses conducted for subjects with and without strabismus indicated that all A&SQ items seemed appropriate for individuals with strabismus (Rasch infit values between 0.60 and 1.40), but several items fitted the model poorly in amblyopes without strabismus. The AS&Q was not found to be unidimensional. CONCLUSIONS. The findings highlight the limitations of the A&SQ instrument in the assessment of VR-QoL in subjects with strabismus and especially in those with amblyopia alone. The results suggest that separate instruments are needed to quantify VR-QoL in amblyopes with and without strabismus

Refractive error changes in cortical, nuclear, and posterior subcapsular cataracts

AIMS: To determine the effect of the three main morphological types of cataract on refractive error. METHODS: Data were prospectively collected from 77 subjects (age 67 (SD 8) years) with one morphological type of cataract. 34 had cortical, 21 had nuclear, and 21 had posterior subcapsular cataract. 22 subjects with clear lenses (60 (7) years) were recruited as controls. The spherical equivalent and astigmatic vector change between spectacle correction and optimal refraction were calculated. RESULTS: The cortical cataract group showed a significant astigmatic change of 0.71 (0.67) D (mean (1 SD)) compared to the control group (0.24 (0.20) D), with 24% outside the 95% confidence limit (0.63 D). The nuclear cataract group showed a significant myopic shift of -0.38 (0.60) D compared to the control group (+0.02 (0.21) D), with 52% beyond the minus 95% confidence limit (-0.39 D). CONCLUSION: A quarter of subjects with cortical cataract showed larger changes in astigmatism than subjects with clear lenses. This is probably because of the localised refractive index changes along cortical spoke opacities within the pupillary area. The well known myopic shift of nuclear cataract was also demonstrated

Visual acuity versus letter contrast sensitivity in early cataract

AbstractLarge and small letter contrast sensitivity and visual acuity were assessed in 37 elderly eyes (mean VA −0.01 logMAR, Snellen 6/6) and their lens opacities were categorised and graded using the LOCS III system. Large letter contrast sensitivity was often not reduced in cataract from age-matched normal values and provided limited information. Small letter contrast sensitivity was shown to be a more sensitive measure of early cataract than visual acuity and large letter contrast sensitivity. Its usefulness may be limited by its strong correlation with visual acuity (r2=0.70), which is the standard and traditional measure of vision in cataract

Most Sub-Arcsecond Companions of Kepler Exoplanet Candidate Host Stars are Gravitationally Bound

Using the known detection limits for high-resolution imaging observations and the statistical properties of true binary and line-of-sight companions, we estimate the binary fraction of {\it Kepler} exoplanet host stars. Our speckle imaging programs at the WIYN 3.5-m and Gemini North 8.1-m telescopes have observed over 600 {\it Kepler} objects of interest (KOIs) and detected 49 stellar companions within $\sim$1 arcsecond. Assuming binary stars follow a log-normal period distribution for an effective temperature range of 3,000 to 10,000 K, then the model predicts that the vast majority of detected sub-arcsecond companions are long period ($P>50$ years), gravitationally bound companions. In comparing the model predictions to the number of real detections in both observational programs, we conclude that the overall binary fraction of host stars is similar to the 40-50\% rate observed for field stars

Understanding The Effects Of Stellar Multiplicity On The Derived Planet Radii From Transit Surveys: Implications for Kepler, K2, and TESS

We present a study on the effect of undetected stellar companions on the derived planetary radii for the Kepler Objects of Interest (KOIs). The current production of the KOI list assumes that the each KOI is a single star. Not accounting for stellar multiplicity statistically biases the planets towards smaller radii. The bias towards smaller radii depends on the properties of the companion stars and whether the planets orbit the primary or the companion stars. Defining a planetary radius correction factor $X_R$, we find that if the KOIs are assumed to be single, then, {\it on average}, the planetary radii may be underestimated by a factor of $\langle X_R \rangle \approx 1.5$. If typical radial velocity and high resolution imaging observations are performed and no companions are detected, this factor reduces to $\langle X_R \rangle \approx 1.2$. The correction factor $\langle X_R \rangle$ is dependent upon the primary star properties and ranges from $\langle X_R \rangle \approx 1.6$ for A and F stars to $\langle X_R \rangle \approx 1.2$ for K and M stars. For missions like K2 and TESS where the stars may be closer than the stars in the Kepler target sample, observational vetting (primary imaging) reduces the radius correction factor to $\langle X_R \rangle \approx 1.1$. Finally, we show that if the stellar multiplicity rates are not accounted for correctly, occurrence rate calculations for Earth-sized planets may overestimate the frequency of small planets by as much as $15-20$\%.Comment: 10 pages, 6 Figures, Accepted for publication in The Astrophysical Journal (Fix typo in Equation 6 of original astroph submission; correction also submitted to Journal

Speckle Camera Observations for the NASA Kepler Mission Follow-up Program

We present the first results from a speckle imaging survey of stars classified as candidate exoplanet host stars discovered by the Kepler mission. We use speckle imaging to search for faint companions or closely aligned background stars that could contribute flux to the Kepler light curves of their brighter neighbors. Background stars are expected to contribute significantly to the pool of false positive candidate transiting exoplanets discovered by the Kepler mission, especially in the case that the faint neighbors are eclipsing binary stars. Here, we describe our Kepler follow-up observing program, the speckle imaging camera used, our data reduction, and astrometric and photometric performance. Kepler stars range from R = 8 to 16 and our observations attempt to provide background non-detection limits 5-6 mag fainter and binary separations of ~0.05-2.0 arcsec. We present data describing the relative brightness, separation, and position angles for secondary sources, as well as relative plate limits for non-detection of faint nearby stars around each of 156 target stars. Faint neighbors were found near 10 of the stars

Adaptive gait changes due to spectacle magnification and dioptric blur in older people

YesPurpose. A recent study suggested that updated spectacles could increase falls rate in older people. We hypothesized that this may be due to changes in spectacle magnification and this study assessed the effects of spectacle magnification on adaptive gait. Methods. Adaptive gait and visual function was measured in 10 older adults (mean age 77.1 ¿ 4.3 years) with the participants¿ optimal refractive correction and when blurred with +1.00DS, +2.00DS, -1.00DS and -2.00DS lenses. Adaptive gait measurements for the lead and trail foot included foot position before the step, toe clearance of the step edge and foot position on the step. Vision measurements included visual acuity, contrast sensitivity and stereoacuity. Results. The blur lenses led to equal decrements in visual acuity and stereoacuity for the +1.00DS and -1.00DS and the +2.00DS and -2.00DS lenses. However, they had very different effects on adaptive gait compared to the optimal correction: Positive blur lenses led to an increased distance of the feet from the step, increased vertical toe clearance and reduced distance of the lead heel position on the step. Negative lenses led to the opposite of these changes. Conclusion. The adaptive gait changes did not mirror the effects of blur on vision, but were driven by the magnification changes of the lenses. Steps appear closer and larger with positive lenses and further away and smaller with negative ones. Magnification likely explains the mobility problems some older adults have with updated spectacles and after cataract surgery.Federation of Ophthalmic and Dispensing Optician

Observations of Binary Stars with the Differential Speckle Survey Instrument. III. Measures below the Diffraction Limit of the WIYN Telescope

In this paper, we study the ability of CCD- and electron-multiplying-CCD-based speckle imaging to obtain reliable astrometry and photometry of binary stars below the diffraction limit of the WIYN 3.5 m Telescope. We present a total of 120 measures of binary stars, 75 of which are below the diffraction limit. The measures are divided into two groups that have different measurement accuracy and precision. The first group is composed of standard speckle observations, that is, a sequence of speckle images taken in a single filter, while the second group consists of paired observations where the two observations are taken on the same observing run and in different filters. The more recent paired observations were taken simultaneously with the Differential Speckle Survey Instrument, which is a two-channel speckle imaging system. In comparing our results to the ephemeris positions of binaries with known orbits, we find that paired observations provide the opportunity to identify cases of systematic error in separation below the diffraction limit and after removing these from consideration, we obtain a linear measurement uncertainty of 3-4 mas. However, if observations are unpaired or if two observations taken in the same filter are paired, it becomes harder to identify cases of systematic error, presumably because the largest source of this error is residual atmospheric dispersion, which is color dependent. When observations are unpaired, we find that it is unwise to report separations below approximately 20 mas, as these are most susceptible to this effect. Using the final results obtained, we are able to update two older orbits in the literature and present preliminary orbits for three systems that were discovered by Hipparcos

Subjective Verticality Is Disrupted by Astigmatic Visual Distortion in Older People

YesPURPOSE: There is little research evidence to explain why older adults have more problems adapting to new spectacles incorporating astigmatic changes than younger adults. We tested the hypothesis that astigmatic lenses oriented obliquely would lead to errors in verticality perception that are greater for older than younger adults. METHODS: Participants included 12 young (mean ± SD age 25.1 ± 5.0 years) and 12 older (70.2 ± 6.3 years) adults with normal vision. Verticality perception was assessed using a computer-based subjective visual vertical (SVV) task, under static and dynamic (in the presence of a moving peripheral distractor) conditions and when viewing targets through the near refractive correction (control condition), and two forms of astigmatic lenses oriented in the vertical, horizontal, and oblique meridians. RESULTS: The older group demonstrated much greater dynamic SVV errors (e.g., 3.4° for the control condition) than the younger group (1.2°, P = 0.002), larger errors with vertical and horizontal astigmatic lenses (older group 4.1°and 5.2° for toric and magnifier lenses vs. younger group 1.2° and 1.4°, respectively, P < 0.001), and a larger influence of the oblique astigmatic lenses (older group 5.6° vs. younger group 2.1°, P<0.001). CONCLUSIONS: Astigmatic lenses produced little or no errors in SVV in young adults, but large static and dynamic SVV errors in older adults. This indicates a greater reliance on visual input with increased age for SVV, and helps explain why oblique astigmatic refractive corrections can cause dizziness in older patients and why they report greater difficulties adapting to new spectacles with astigmatic changes