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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.
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.
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
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
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)
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.