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Fragestellung: Ist es sinnvoll im Kindesalter restriktiv einen UV-Schutz für die Augen anzuwenden, obwohl UV-Strahlung eine schützende Wirkung für das Entstehen einer Myopie hat?
Einleitung: Die Myopie ist eine typischerweise durch Längenwachstum des Augapfels verursachte Fehlsichtigkeit mit stark steigender Prävalenz in den letzten Jahrzenten. UV-Strahlung hat auf die Haut und die Augen eine Vielzahl negativer Auswirkungen. Nebst der akuten Photokeratitis sind Pinguecula, Pterygium, Plattenepithelneoplasie, Katarakt, AMD und maligne Melanome chronische Veränderungen. Andererseits bremst UV-Strahlung das Fortschreiten des Augenlängenwachstums.
Modellrechnung: Mittels dem evidenzbasierten Modellrechner kann das Risiko einer Myopie und deren Stärke anhand des Jahrgangs, der Sonnenschutzanwendung, der familiären Prädisposition, der Zeit im Freien und des Bildungsgrades berechnet werden. Gelegentlich angewandter Sonnenschutz hat gegenüber häufig angewandtem Sonnenschutz einen Schutzfaktor für die Myopieentstehung von 1.03. Das grösste Risiko einer Myopie kommt von der familiären Prädisposition.
Diskussion: Zeit im Freien hat einen grossen hemmenden Effekt auf die Myopie, Sonnenschutzanwendung nur einen leicht Fördernden. Zudem hat Sonnenschutz einen stark hemmenden Effekt auf UV-bedingte Augen- und Hauterkrankungen. Auf Sonnenschutz der Augen zu verzichten, um eine Myopie zu verhindern oder im Fortschreiten zu bremsen, scheint unvernünftig.
Ziel: Eine Analyse der aktuellen wissenschaftlichen Literatur zu Orthokeratologie bei Myopie. Es werden Studienergebnisse zu verschiedenen Aspekten der Orthokeratologie miteinander verglichen und auf ihre Übereinstimmung überprüft. Der Fokus wird auf die Veränderungen der visuellen Wahrnehmung und der kornealen Beschaffenheit während und nach der Anwendung von Orthokeratologie gelegt.
Abstract
1.1 Purpose
The purpose of this study is to prescribe follicular-like conjunctivitis associated with Siliconhydrogels
(FoCoSi) in silicone hydrogel contact lens wearers as a novel subtype of
the well prescribed contact lens induced papillary conjunctivitis (CLPC).
1.2 Methods
1211 patients who wore silicon hydrogels were included in this prospective, nonrandomised,
single center study. Subjective symptoms and clinical signs were evaluated
for daily wear (DW) and continuous wear (CW) populations for several (Lotrafilcon A,
Lotrafilcon B, Senofilcon A, Galyfilcon A) silicon hydrogel lens types. CCLRU and other
specifically developed grading scale were utilized for evaluation. Grading of 2 and above
was rated as clinically significant. Statistical evaluation was performed for eyes rather
than subjects.
1.3 Results
The clinical presentation of FoCoSi could be confirmed and showed an incidence of
3.8%. Lotrafilcon A followed by Senofilcon A on a CW modality presented, with a risk
ratio of 2.49 and 1.53 respectively, the highest affinity for developing FoCoSi. Fluorescein
positive spots showed the closest correlation with subjective symptoms reported
by patients and divided FoCoSi into an active and dormant form. Besides Protein, Lipid
deposition on the contact lens surface and air pollution like Ozone or fine and ultrafine
particles seems to be important factors in developing FoCoSi, whereas mechanical irritation
played a minor role.
1.4 Conclusion
FoCoSi is a novel and relevant subtype of CLPC. Further studies should be performed
to validate these findings and clear up several questions about the aetiology of FoCoSi
and CLPC.
Keywords: Giant papillary conjunctivitis (GPC), contact lens-induced papillary conjunctivitis
(CLPC), follicular-like conjunctivitis associated with siliconhydrogels (FoCoSi)
Ziele: Ziel dieser Arbeit ist es, eine funktionierende Software zu entwickeln, die es ermöglicht, aufgrund von verschiedenen Messungen, einen evidenzbasierten Therapievorschlag zur Behandlung des trockenen Auges zu generieren. Sie soll an das jeweilige örtliche Angebot von Mess- und Therapieoptionen anpassbar sein, um das große und oft unübersichtliche Angebot an Therapieoptionen effizienter und somit wirtschaftlicher nutzen zu können.
Purpose
The purpose of this study was to investigate the correlation of measured visual acuity
(VA) both static and dynamic obtained with static and dynamic measuring tests, as well
as, response time to visual stimulus and analysis of its influence on dynamic visual
acuity. The aim was to compare the results gathered for the three age groups and
analyze the possible differences.
Methods
The test groups consisted of 75 subjects between 10 and 60 years old, categorized in
three age groups. The measurements of static and dynamic visual acuity and reaction
time were conducted. The set of nine tests (five with radial magnification speed and four
simulating driving condition at 72 km/h and 130 km/h) was designed in order to measure
dynamic visual acuity and the set of two tests for reaction time measurement.
Results
Compared to static visual acuity in both tests, the results obtained with measurements
of dynamic visual acuity resulted in lower values depending on Landolt ring size and
magnification speed of animation. In average, the dynamic visual acuities in tests with
different magnification speeds were lower than static by 0.4 visual acuity units, or 31%
and the average of dynamic visual acuity after subtracting motoric component (reaction
time) was for 0.2 visual acuity worse than static or 15%. In the second test simulating
driving conditions at 72 km/h the average drop in dynamic visual acuity was 33% while
at 130 km/h average drop for younger and middle age groups was 37% and for older
group was 44% and after subtracting motor component values for 72 km/h speed
simulation average drop in visual acuity values was 23% for all three groups; for 130
km/h speed simulation younger and middle aged group average drop of visual acuity
was 20% and with older group it was 24%.
Conclusion
The tests used in this study were simple and fast and revealed significant difference
between static and dynamic visual acuity and influence of reaction time on dynamic
Nataša Vujko Muždalo Abstract
2
visual acuity values. It is hoped that this thesis will be a positive contribution in testing
and training of dynamic visual and sensory response skill with drivers, sportsmen and
people with visual-motor dysfunction.
Keywords: Dynamic visual acuity (DVA), static visual acuity (SVA), reaction time (RT),
motoric component, dynamic visual acuity test, reaction time test, radial increase in size
The increasing prevalence of myopia throughout the industrialized world in recent decades has caused costs and problems for the eye health. Changed lifestyle and behavior are the main causes. For the pathogenesis of myopia, the amount of time spent outdoor and near activities play an important role. Various options for the treatment of myopia have been described as effective in the literature. Normal single vision glasses and contact lenses can only provide clear vision, but do not reduce myopia progression. Orthokeratology shows a slowing of axial growth, but has an increased risk of infectious keratitis. Low-dose atropine (0.01%) is currently the best pharmacological option. It proved safe, effective and showed the least rebound effect with negligible side effects. Other options for the treatment of myopia include special glasses, behavioral changes and prolonged outdoor exposure (to prevent the onset of myopia), as well as other methods. An increasingly important myopia management option is multifocal contact lenses, that provide a peripheral treatment zone producing myopic defocus. Such myopia control lenses are available as customized or as daily or monthly lenses. Children benefit from wearing contact lenses more than just having refractive error correction and myopia control, they have a better self-esteem and improved quality of life. The numerous findings on the safety and efficacy of soft multifocal distance center contact lenses in children to reduce the progression of myopia suggest that this modality should be considered as a main treatment option. Less, but similar to orthokeratology, when wearing soft lenses there is a risk of developing potentially serious complications such as microbial keratitis. The introduction of child-appropriate risk minimization strategies, and patient and parent education with regular monitoring is essential and leads to successful contact lens wear. This literature review summarized the actual knowledge about myopia management, prevalence, etiology and the visual and healthy consequences of myopia.
The three currently most important strategies for slowing the progression of myopia are soft multifocal distance center contact lenses, Orthokeratology and low-dose atropine ophthalmic drops.
Purpose: Usually, a theory of attention upon gazed-at locations is applied. More parameters than gaze location can be derived to improve the theory of attention allocation. The aim of this study was to identify parameters related to eye tracking, that are suitable indicators of attention.
Methods: Binocular eye tracking data was collected with the Eye Tribe tracking system (The Eye Tribe Aps, Copenhagen, Denmark) for the task of visual exploration of the painting “Unexpected Visitors” by Ilya Repin. 20 subjects (valid data: 19/20) had to look at this painting for about two and a half minutes in order to generate fatigue and inattention. In a second step, suitable parameters of attention were transferred to a data set (8 subjects, valid data: 6/8) on a perimetric task executed with the OCTOPUS 900 perimeter (Haag-Streit, Köniz, Switzerland). Monocular parameters could be applied on the perimetric task, the error rate (false positive and false negative catch trials, 5 % each) were taken as additional parameter.
Results: For the image viewing task, the only parameter showing significance was the average level (a10) of fatigue waves (p = 0.00024, ANOVA, ∆ = -0.8316 px). Blink duration (∆ =-270.4 ms), pupil variability (∆ = -0.17868), saccade length (∆ =-0.3135 px) and fixation duration (∆ = 186.5 ms) did not change significantly, but showed relevant trends by differences ∆ of their median between the first and last tenth of the recording time. Blink rate and the Index of Cognitive Activity (ICA) did neither show significant changes nor relevant trends. Vergence accuracy failed to indicate fatigue due to variability between subjects and comparatively small effect size. For the perimetric data, in 3 of 6 subjects fatigue waves over a limited time window could be observed. Only for one subject, a relevant increase in false negative responses to catch trials (50 percentage points) could be observed.
Conclusion: Pupil diameter variability, saccade length, fixation duration and fatigue waves were the parameters indicating fatigue. Only the latter parameter has the potential to be applied to perimetric data.
In Branchen wie Luftfahrt, Hotellerie oder Autovermietungen gehört «Revenue-Marketing» (kurz: RM) in Form von dynamischer Preisgestaltung schon lange zum angewendeten Standard. Ziel dieser Studie ist herauszufinden, wie die Haltung der schweizerischen Augenoptikerbranche gegenüber «Revenue-Marketing» ist. Es wird analysiert, wie viele Augenoptikfachgeschäfte in der Schweiz dynamische Preise anwenden und wie viele diese nicht anwenden. Es wird analysiert, wie die dynamischen Preise gesteuert werden und welche Produkte betroffen sind. Werden noch keine dynamischen Preise verwendet, wird nachgefragt, ob eine mögliche Einführung geplant ist. Sofern keine Einführung geplant ist, werden die Ablehnungsgründe analysiert. Zudem wird geforscht, ob die Firmengrösse einen Einflussfaktor auf die Verwendung von «Revenue-Marketing» hat.
This research project is of particular importance since there is a lack of adequate data on pediatric eye and vision disorders in Russia, particularly in the Volga region. In the present study, we estimate the prevalence of vision disorders among school-aged children who participated in a vision screening program in Samara, Russia. The relationship between learning-related visual dysfunctions is explored in depth, such to illustrate the connection between vision and learning. Hence, a key feature in this study is the inclusion of binocular vision disorders among the conditions tested.
Die Bevölkerungsversorgung mit medizinischen Leistungen stellt zunehmend eine größere Herausforderung dar. Durch demographische Veränderungen unserer Gesellschaft ist ein deutlicher Anstieg des augenärztlichen Versorgungsbedarfs erkennbar. Trotz steigender Zahl an Ophthalmologen zeigt sich keine entsprechende Zunahme der augenärztlichen Versorgungskapazität. In der Zukunft wird eine flächendeckende und hochqualitative Versorgung nicht mehr möglich sein, solange nicht mit Aufstockung der notwendigen Ressourcen auf den steigenden Versorgungsbedarf reagiert wird.
Purpose
Automated scanpath comparison metrics should deliver an objective method to
evaluate the similarity of scanpaths. The aim of this thesis is an evaluation of
seven existing scanpath comparison metrics in static and dynamic tasks in order
to provide a guidline that helps to decide which algorithm has to be chosen for a
special kind of task.
Methods
The applicability of the algorithms for a static, visual search task and a dynamic,
interactive video game task as well as their constraints and limitations were tested.
Therefore, binocular gaze data were recorded by using the eye tracking system The
Eye Tribe (The Eye Tribe ApS, Copenhagen/ Denmark). Objective task performance
measures from 21 subjects were used in order to create scanpath groupings
for which a relevant effect of dissimilarity was to be expected. Objective task performance
measures such as task performance time were statistically evaluated and
compared to the results gained by the comparison metrics.
Results
Four of the algorithms being used successfully identified differences for static and
dynamic tasks: MultiMatch, iComp, SubsMatch and the Hidden Markov Model.
ScanMatch was very sensitive for the static task but not applicable to the dynamic
task whereas FuncSim was suitable for dynamic but not for static tasks. Eyenalysis
failed to detect any effect.
Conclusion
The applicability of scanpath comparison metrics depends on the state of the task,
respectively on the kind of experimental set up. In future, the application area for
eye tracking will expand and an improvement of automated scanpath comparison
metrics is therefore required.
„Gelernt ist längst nicht mehr gelernt”- Weiterbildung und Qualifizierung sind der Schlüssel für die Arbeit von morgen, erklärte Bundesarbeitsminister Hubertus Heil am 21.11.2019. „Die Beschäftigten von heute müssen auch die Arbeit von morgen machen können”, lautete der zentrale Satz, mit dem Hubertus Heil den Grundstein für die Debatte legte. Durch den digitalen Wandel der Arbeitswelt werden sich Berufe, Tätigkeiten und Qualifikationsprofile massiv verändern. „Lebenslanges Lernen” dürfe dabei aber nicht als Bedrohung wahrgenommen werden. (1) Um das Wissen und Können auf dem neuesten technologischen Stand zu halten, wird Weiterbildung immer wichtiger, nicht nur für Geringqualifizierte, sondern auch für Fachkräfte. (2) Moderne Geräte führen heute für den*die Kunden*Kundin unterschiedliche Screenings durch und messen zeitgleich die Sehstärke unter Tag- und Nachtbedingungen. Tragbare Funduskameras ermöglichen ohne Pupillenerweiterung das Erkennen und Überwachen von Netzhauterkrankungen. (3) All diese Geräte sind einfach und ohne besondere Qualifikation zu bedienen. Trotz der zunehmenden telemedizinischen Unterstützung ist eine fundierte optometrische Ausbildung unentbehrlich um sich nicht von dieser telemedizinischen Unterstützung abhängig zu machen oder noch bedenklicher, den*die Kunden*Kundin mit Halbwissen vermeintliche Sicherheit über seinen*ihren Gesundheitszustand zu vermitteln. Auch befinden wir uns mitten im demografischen Wandel. Die steigende Zahl älterer Menschen bedeutet nicht nur ein Anstieg von Brillenträgern, sondern auch eine Zunahme an altersbedingten Veränderungen am Auge. (4) Gleichzeitig nimmt die Zahl der Augenärzte stetig ab, ab von den großen Städten herrscht in der Augenheilkunde ein großer Ärztemangel. (5) Der*die Augenoptiker*in Zukunft wird zunehmend in den Bereich Früherkennung und Prävention miteinbezogen. Dazu benötigt er*sie entsprechende Kenntnisse und Qualifikationen eines*einer Optometristen*in, um diese optometrischen Dienstleistungen anbieten zu können. Die zunehmende Digitalisierung ermöglicht zusätzlich nützliche persönliche und kompetente Beratung auf hohen fachlichen Niveau. Diese Masterthesis gibt einen Überblick über die aktuelle Ausbildungssituation und welche berufsbegleitenden Weiterbildungsmöglichkeiten für Augenoptikergesellen*innen, Augenoptikermeister*innen, Staatlich geprüfte Augenoptiker*innen und Dipl.-Ing. für Augenoptik (FH) in Deutschland zur Verfügung stehen.
Diese Masterarbeit beschäftigt sich mit "Race Conditions", auf Deutsch "Wettlaufsituationen", in Webanwendungen. Bei dieser Art von Schwachstelle lassen sich durch einen Angreifer unvorhergesehene Zustände, in Folge von überschneidenden und parallelen Programmcodesequenzen, kreieren. Durch geschicktes Ausnutzen dieser Zustände können sich damit Vorteile verschafft werden, wie das Umgehen von Anti-Brute-Force-Mechanismen, das Überziehen von Limits, die Mehrabgabe von Stimmen und weiteren Angriffsszenarien. Im Rahmen der Arbeit wird ein Penetration Testing Tool für Race Conditions und eine Trainings-Webanwendung entwickelt, die für diese Art von Angriffen verwundbar ist. Anhand des entwickelten Penetration Testing Tools und der entwickelten Webanwendung werden Angriffsszenarien aus der Praxis demonstriert.
Demographische Veränderungen durch eine zunehmende Alterung der Gesellschaft und eine Zunahme an Erkrankungen wie der AMD, des Glaukoms und der diabetischen Retinopathie stellen ophthalmologische Versorgungs- und Vorsorgemaßnahmen in Deutschland vor immer größere Herausforderungen. Einen wesentlichen Beitrag zur Sicherung der Vorsorgemaßnahmen können in der Zukunft Optometristen leisten. Mit Hilfe modernster Technologien, wie dem Ultra-Widefield-cSLO (Optos Daytona, können auch bei kleinen Pupillendurchmessern 200° Aufnahmen vom Augenhintergrund erstellt werden.
Novel myopia control spectacle lenses induce peripheral contrast reduction via optical diffusion. It is suggested, that the contrast reduction alters retinal processes in the low-level neural circuity, leading to an inhibition of eye growth. The purpose of this thesis is to evaluate the influence of full-field contrast reduction on low-level neural processing of the retina, described by the edge contrast sensitivity.
A good stereopsis (depth perception) is needed in everyday life, regardless whether a person is a professional driver or chef. Good estimation of distance, and of what is further and what closer, could mean the difference between a crushed and a whole car or between a bloody and a healthy finger. The main theme of this Master thesis is detect and quantify major factors in depth perception. Do the younger estimate the depth better than the older; do they have better depth perception with greater or smaller pupil distance; does depth perception depend on gender; what happens with stereopsis when vision is fogged by +0,5 and +1,0 D? These are the questions dealt with in this Master thesis.
To answer these questions measurements were made on 51 subjects (mean age 45,0 +/- 13,32 years) of whom 25 were women, mean age 45,5 +/-13,55 years (12 with PD<62 mm, mean and 13 with PD>66 mm) and 26 men, mean age 44,4 +/- 13,34 years (13 with PD<62 mm and, 13 with PD >66 mm). Each of these four groups was further divided by age (one in range 20 to 35 years and second in range 50 to 65 years).
The measurements were made with a few assumptions. The first assumption was that stereopsis is in direct correlation with visual acuity, the second assumption was that persons with bigger interpupillar distance have better stereopsis, and the third assumption was that with age the stereopsis ability decreases.
The measurements were done with modified Frisby–Davis test expanded from four geometrical shapes to twenty-five circles. The stereopsis was measured with full refractive correction at 4,5 and 3,0 meters. Later, stereopsis was measured with fogging with +0,5 and +1,0 D at the 4,5 and 3,0 meter distances.
Statistically there is no correlation (or very weak) between stereopsis and the visual acuity for whole group of 51 test persons, but if only young test persons are taken in consideration, the correlation becomes significant, r(20)=0,566, p=0,009 at 4,5 m and r(20)=0,456, p=0,043 at 3,0 m and that matches the assumption. Stereopsis is in no or weak positive correlation with pupil distance r(51)=0,059, p=0,679, which is in total contrast to the assumption. Stereopsis is in positive correlation with age at 4,5 meters measuring distance, r(51)=0,371, p=0,007, which corresponds to assumption. In addition, stereopsis is better in females than in males by 32,5%.
Based on the results it can be concluded that the stereopsis is in negative correlation with age, in positive correlation with visual acuity, females have better stereopsis than males and statistically, the correlation between stereopsis and pupil distance (PD) has not been proved. The most important conclusion is that the decreased visual acuity brings significant fall of stereopsis. A deficit in refraction of -0,50 D decreases stereo acuity by about 90% (nearly 2x) and a deficit of -1,0 D decreases stereo acuity by about 220% (about 3x).
Keywords: Stereopsis, stereo acuity, depth perception, pupil distance (PD), visual acuity (VA).
EMDR-Therapie im Vergleich zu EMDR-Therapie, erweitert durch taktilen und auditorischen Stimulus
(2023)
EMDR (Eye Movement Desensitization and Reprocessing) ist ein neurobiologisch orientierter psychotherapeutischer Ansatz zu Behandlung von posttraumatischen Belastungsstörungen (PTBS) und anderen belastenden Lebensereignissen. Dabei werden Augenbewegungen eingesetzt, um die Verarbeitung und Integration traumatischer Erinnerungen zu erleichtern. Diese nichtinterventionelle Anwendungsbeobachtung untersucht die Bedeutung von Augenbewegungen in EMDR und potenzielle Vorteile der Einbeziehung auditiver und taktiler Reize in die Therapie.
The purpose of this master thesis is to make a manual on cataracts so that optometrists in the Republic of Croatia have in one place everything about the causes, diagnosis, and treatment of cataracts. According to the World Health Organization cataract is one of the leading causes of vision impairment in the world. By properly diagnosing the type of cataract, we provide patients with a better quality of life and a visual aid with which they will achieve maximum visual acuity. This master’s thesis will summarize all the knowledge from the master's degree in Aalen in order to get a broader picture of the formation of cataracts. On daily basis optometrists encounter cataract pathology, the goal is to better understand what affects cataract formation, from drugs to systemic diseases, and to ultimately help the client see better after resolving cataract pathology.
Purpose
The purpose of this study was to evaluate the validity of the iPad Aniseikonia Test for
measurement size lens-induced aniseikonia. The iPad Aniseikonia Test is a new
computer-based test designed for measuring aniseikonia in vertical direction. The iPad
Test uses red-green anaglyphs.
Methods
Aniseikonia was induced in 21 subjects by means of afocal size lenses. Resulting
aniseikonia was measured in vertical direction by the iPad Aniseikonia Test. The
measurement was performed in dark condition with appropriate correction of refractive
error. All subject were patients with normal vision with no anisometropia or other
ocular problem.
Results:
Afocal size lenses of known magnification were used to induce aniseikonia. 5
measurements were taken in each subject, ranging from zero to 7 % magnification.
When using the regression analysis, the slope of the fitted line significantly differs from
1. The average slope of regression line is 0,58.
Conclusions:
Only moderate accuracy was found for tested target size and orientation. In all cases the
iPad Aniseikonia Test underestimates the level of aniseikonia. However for gross
assessment of anisometropia in clinical practice it could be successfully used. Further
study with different target size should be addressed.