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Abraham CH, Sakyi-Badu G, Boadi-Kusi SB, Morny E, Darko-Takyi C, Ocansey S, Hope PKF, Dadzie AK, Aboagye MacCarthy A, Osei-Frimpong K, Nyarkoa Opoku E, Kwasi Abu E. Simulation of visual impairment in persons with normal vision for scientific research. Ophthalmic Physiol Opt 2024; 44:442-456. [PMID: 38223917 DOI: 10.1111/opo.13268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 01/16/2024]
Abstract
Simulation of visual impairment in healthy eyes has multiple applications in students' training, research and product development. However, due to the absence of an existing standard protocol, the method of simulation was left to the discretion of the researcher. This review aimed to outline the various methods of simulating visual impairment and categorising them. A scoping review of the relevant publications was conducted. Of the 1593 articles originally retrieved from the databases, 103 were included in the review. The characteristics of the participants, the method for simulation of the visual impairment in persons with normal vision and the level or type of visual impairment that was simulated were extracted from the papers. None of the methods of simulation can be judged as being superior to the others. However, electronic displays produced the most consistent form of visual impairment simulation.
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Affiliation(s)
- Carl Halladay Abraham
- Department of Optometry and Vision Science, University of Cape Coast, Cape Coast, Ghana
| | - Godfred Sakyi-Badu
- Department of Optometry and Vision Science, University of Cape Coast, Cape Coast, Ghana
| | | | - Enyam Morny
- Department of Optometry and Vision Science, University of Cape Coast, Cape Coast, Ghana
| | - Charles Darko-Takyi
- Department of Optometry and Vision Science, University of Cape Coast, Cape Coast, Ghana
| | - Stephen Ocansey
- Department of Optometry and Vision Science, University of Cape Coast, Cape Coast, Ghana
| | | | - Albert Kofi Dadzie
- Department of Optometry and Vision Science, University of Cape Coast, Cape Coast, Ghana
| | | | | | | | - Emmanuel Kwasi Abu
- Department of Optometry and Vision Science, University of Cape Coast, Cape Coast, Ghana
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Nguyen H, Di Tanna GL, Coxon K, Brown J, Ren K, Ramke J, Burton MJ, Gordon I, Zhang JH, Furtado J, Mdala S, Kitema GF, Keay L. Associations between vision impairment and vision-related interventions on crash risk and driving cessation: systematic review and meta-analysis. BMJ Open 2023; 13:e065210. [PMID: 37567751 PMCID: PMC10423787 DOI: 10.1136/bmjopen-2022-065210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
OBJECTIVES To systematically investigate the associations between vision impairment and risk of motor vehicle crash (MVC) involvement, and evaluate vision-related interventions to reduce MVCs. DESIGN Medline (Ovid), EMBASE and Global Health electronic databases were systematically searched from inception to March 2022 for observational and interventional English-language studies. Screening, data extraction and appraisals using the Joanna Briggs Institute appraisal tools were completed by two reviewers independently. Where appropriate, measures of association were converted into risk ratios (RRs) or ORs for meta-analysis. PARTICIPANTS Drivers of four-wheeled vehicles of all ages with no cognitive declines. PRIMARY AND SECONDARY OUTCOMES MVC involvement (primary) and driving cessation (secondary). RESULTS 101 studies (n=778 052) were included after full-text review. 57 studies only involved older drivers (≥65 years) and 85 were in high-income settings. Heterogeneity in the data meant that most meta-analyses were underpowered as only 25 studies, further split into different groups of eye diseases and measures of vision, could be meta-analysed. The limited evidence from the meta-analyses suggests that visual field defects (four studies; RR 1.51 (95% CI 1.23, 1.85); p<0.001; I2=46.79%), and contrast sensitivity (two studies; RR 1.40 (95% CI 1.08, 1.80); p=0.01, I2=0.11%) and visual acuity loss (five studies; RR 1.21 (95% CI 1.02, 1.43); p=0.03, I2=28.49%) may increase crash risk. The results are more inconclusive for available evidence for associations of glaucoma (five studies, RR 1.27 (95% CI 0.67, 2.42); p=0.47; I2=93.48%) and cataract (two studies RR 1.15 (95% CI 0.97, 1.36); p=0.11; I2=3.96%) with crashes. Driving cessation may also be linked with glaucoma (two studies; RR 1.62 (95% CI 1.20, 2.19); p<0.001, I2=22.45%), age-related macular degeneration (AMD) (three studies; RR 2.21 (95% CI 1.47, 3.31); p<0.001, I2=75.11%) and reduced contrast sensitivity (three studies; RR 1.30 (95% CI 1.05, 1.61); p=0.02; I2=63.19%). Cataract surgery halved MVC risk (three studies; RR 0.55 (95% CI 0.34, 0.92); p=0.02; I2=97.10). Ranibizumab injections (four randomised controlled trials) prolonged driving in persons with AMD. CONCLUSION Impaired vision identified through a variety of measures is associated with both increased MVC involvement and cessation. Cataract surgery can reduce MVC risk. Despite literature being highly heterogeneous, this review shows that detection of vision problems and appropriate treatment are critical to road safety. PROSPERO REGISTRATION NUMBER CRD42020172153.
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Affiliation(s)
- Helen Nguyen
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Gian Luca Di Tanna
- George Institute for Global Health, The University of New South Wales, Sydney, New South Wales, Australia
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Kristy Coxon
- School of Health Sciences, and the Translational Health Research Institute, Western Sydney University-Campbelltown Campus, Campbelltown, New South Wales, Australia
| | - Julie Brown
- George Institute for Global Health, The University of New South Wales, Sydney, New South Wales, Australia
| | - Kerrie Ren
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Matthew J Burton
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
- National Institute for Health Research Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Iris Gordon
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Justine H Zhang
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - João Furtado
- Division of Ophthalmology, Universidade de São Paulo Faculdade de Medicina de Ribeirão Preto, Ribeirao Preto, São Paulo, Brazil
| | - Shaffi Mdala
- Ophthalmology Department, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Gatera Fiston Kitema
- Ophthalmology Department, University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
| | - Lisa Keay
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
- George Institute for Global Health, The University of New South Wales, Sydney, New South Wales, Australia
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Savage SW, Zhang L, Swan G, Bowers AR. Head Scanning Behavior Predicts Hazard Detection Safety Before Entering an Intersection. HUMAN FACTORS 2023; 65:942-955. [PMID: 34435529 PMCID: PMC9246243 DOI: 10.1177/00187208211039102] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE We conducted a driving simulator study to investigate scanning and hazard detection before entering an intersection. BACKGROUND Insufficient scanning has been suggested as a factor contributing to intersection crashes. However, little is known about the relative importance of the head and eye movement components of that scanning in peripheral hazard detection. METHODS Eleven older (mean 67 years) and 18 younger (mean 27 years) current drivers drove in a simulator while their head and eye movements were tracked. They completed two city drives (42 intersections per drive) with motorcycle hazards appearing at 16 four-way intersections per drive. RESULTS Older subjects missed more hazards (10.2% vs. 5.2%). Failing to make a scan with a substantial head movement was the primary reason for missed hazards. When hazards were detected, older drivers had longer RTs (2.6s vs. 2.3s), but drove more slowly; thus, safe response rates did not differ between the two groups (older 83%; younger 82%). Safe responses were associated with larger (28.8° vs. 20.6°) and more numerous (9.4 vs. 6.6) gaze scans. Scans containing a head movement were stronger predictors of safe responses than scans containing only eye movements. CONCLUSION Our results highlight the importance of making large scans with a substantial head movement before entering an intersection. Eye-only scans played little role in detection and safe responses to peripheral hazards. APPLICATION Driver training programs should address the importance of making large scans with a substantial head movement before entering an intersection.
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Affiliation(s)
- Steven W. Savage
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA
| | - Lily Zhang
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA
| | - Garrett Swan
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA
| | - Alex R. Bowers
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA
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Humphreys JD, Sivaprasad S. Living Without a Diagnosis: A Patient's Perspective on Diabetic Macular Ischemia. Ophthalmol Ther 2022; 11:1617-1628. [PMID: 35821381 PMCID: PMC9437185 DOI: 10.1007/s40123-022-00546-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/24/2022] [Indexed: 11/25/2022] Open
Abstract
Diabetic macular ischemia (DMI) is a common complication of diabetic retinopathy (DR) that can result in progressive and irreversible vision loss. DMI is associated with damage in the vessels that supply blood to the retina and the enlargement of the foveal avascular zone. Currently, there are no approved treatments specifically for DMI. Furthermore, there is limited published information about the prognosis, prevalence or outcomes of DMI, and there is no consensus regarding diagnostic criteria. It is vital to ensure that there is sufficient, accessible and accurate information available to support patients, caregivers and physicians. To lay the foundation for more research into DMI and its impact on patients, we (a patient with DMI and an expert ophthalmologist) have worked together to interweave our personal perspectives and clinical experiences with a review of currently available literature on DMI. The development of a set of confirmed diagnostic criteria for DMI would assist both patients and physicians, allowing patients to access validated information about their condition and supporting the development of clinical trials for treatments of DMI. Training for physicians must continue to emphasise the importance of treating a patient holistically, rather than only treating their symptoms. Most importantly, developing trust and a healthy rapport between a patient and their physician is important in managing health anxiety and ensuring adherence to beneficial treatments or lifestyle adjustments; physicians must cultivate an open and flexible management approach with their patients. Finally, holistic educational programmes for patients, physicians and the general public around DMI and how it can affect daily functioning would facilitate general understanding and disease awareness. Diabetic macular ischemia (DMI) is a common problem for patients with diabetic retinopathy that can lead to sight loss. There is very little information available about DMI, particularly from a patient’s point of view. To address the lack of information about DMI, we (a person with DMI and her eye doctor) have worked together to examine what it is like to live with DMI.
It is important to provide clear and accessible information about diseases to patients and carers. The lack of information about DMI may be upsetting for some people, and should be addressed with more research. Developing of a set of confirmed signs and symptoms for the diagnosis of DMI would allow people to be more confident in the information that they receive about their disease, and support the development of treatments for DMI.
The support of others is central to the wellbeing of people with vision loss. Although people with vision loss may also lose independence, care from loved ones can help to improve quality of life. Most importantly, developing trust between a patient and their doctor is central to managing people’s fears about their eyesight, and making sure that they follow helpful advice. Doctors must use an open and flexible approach with their patients, providing information in an honest and understandable way. Living Without a Diagnosis: A Patient’s Perspective on Diabetic Macular Ischemia; Audioslides. (MP4 23566 kb)
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Affiliation(s)
| | - Sobha Sivaprasad
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital, 162 City Rd, London, EC1V 2PD, UK.
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