Novel use of video glasses during binocular microscopy in the otolaryngology clinic

INTRODUCTION

The development of portable, high resolution video displays such as video glasses allows clinicians the opportunity to offer patients an increased ability to visualize aspects of their physical examination in an ergonomic and cost-effective manner. The objective of this pilot study is to trial the use of video glasses for patients undergoing binocular microscopy as well as to better understand some of the potential benefits of the enhanced display option.

METHODS

This study was comprised of a single treatment group. Patients seen in the otolaryngology clinic who required binocular microscopy for diagnosis and treatment were recruited. All patients wore video glasses during their otoscopic examination. An additional cohort of patients who required binocular microscopy were also recruited, but did not use the video glasses during their examination. Patients subsequently completed a 10-point Likert scale survey that assessed their comfort, anxiety, and satisfaction with the examination as well as their general understanding of their otologic condition.

RESULTS

A total of 29 patients who used the video glasses were recruited, including those with normal examinations, cerumen impaction, or chronic ear disease. Based on the survey results, patients reported a high level of satisfaction and comfort during their exam with video glasses. Patients who used the video glasses did not exhibit any increased anxiety with their examination. Patients reported that video glasses improved their understanding and they expressed a desire to wear the glasses again during repeat exams.

CONCLUSION

This pilot study demonstrates that video glasses may represent a viable alternative display option in the otolaryngology clinic. The results show that the use of video glasses is associated with high patient comfort and satisfaction during binocular microscopy. Further investigation is warranted to determine the potential for this display option in other facets of patient care as well as in expanding patient understanding of disease and anatomy.

Comparison of Objective and Subjective Changes Induced by Multiple-Pinhole Glasses and Single-Pinhole Glasses

Multiple-pinhole (MPH) glasses are currently sold in many countries with unproven advertisements; however, their objective and subjective effects have not been investigated. Therefore, to investigate the effects of MPH glasses excluding the single-pinhole (SPH) effect, we compared the visual functional changes, reading speed, and ocular discomfort after reading caused by MPH and SPH glasses. Healthy 36 participants with a mean age of 33.1 years underwent examinations of pupil size, visual acuity (VA), depth of focus (DOF), and near point accommodation (NPA); tests for visual field (VF), contrast sensitivity (CS), stereopsis, and reading speed; and a survey of ocular discomfort after reading. Both types of pinhole glasses enlarged pupil diameter and improved VA, DOF, and NPA. However, CS, stereopsis, and VF parameters deteriorated. In comparison with SPH glasses, MPH glasses induced smaller pupil dilation (5.3 and 5.9 mm, P < 0.001) and showed better VF parameters with preserved peripheral VF. However, no significant difference was observed for VA, DOF, NPA, stereopsis, and CS. Reading speed using pinhole glasses was significantly slower than baseline; SPH glasses showed the slowest reading speed. Both types of glasses caused significant ocular discomfort after reading compared with baseline, and symptoms were worst with MPH glasses. In conclusion, both types of pinhole glasses had positive effects due to the pinhole effect; however, they had negative effects on VF, CS, stereopsis, reading speed, and ocular discomfort. In spite of the increased luminance and preserved peripheral VF with MPHs, these glasses caused more severe ocular discomfort than SPH glasses.

Photochromic dynamics of ophthalmic lenses

We describe and characterize a straightforward test setup for characterizing temporal and spectral dynamics of photochromic spectacle materials. Three measurement examples of contemporary silicate and organic photochromic spectacles are provided. The setup showed a good absolute accuracy of ≤5% of the luminous transmittance (τ(v)) and repeatability of better than 3%. The samples showed different fading times. The sample with the highest dynamic range was the slowest and showed a noticeable change in the transmission spectra during deactivation. The silicate had the lowest dynamic range but also the most homogeneous transmission spectra throughout activation and deactivation. The proposed test device provided accurate results for spectral and temporal dynamics of photochromic materials under realistic conditions.

Is esophoria a factor in slowing of myopia by progressive lenses?

PURPOSE

Our previous findings suggest that myopia can be slowed by wearing progressive lenses, and one possible mechanism for this is through the oculomotor system. We reanalyzed our findings to investigate the relationship between baseline oculomotor parameters and change in refraction, and between the change in these values and change in refraction.

METHODS

Children who wore progressive lenses (N = 38; 26 with +1.50 D addition, and 16 with +2.00 D addition) or single-vision lenses (N = 32) had refraction, distance heterophoria, near heterophoria, and stimulus AC/A ratio measured prospectively over a 2-year period.

RESULTS

There were no statistically significant correlations between baseline heterophoria or AC/A values and change in refractive error. Distance and near heterophoria did not change significantly over the 2 years of the experiment; AC/A ratio decreased significantly, but in an equivalent manner for both groups. In the combined progressive lens group, change toward more exophoria at near was associated with less myopia progression. However three-way analysis of variance (visit x lens type x esophoria/nonesophoria) showed significant main effects in refraction over all five visits. There was a significant interaction between lens type and visits; there was no significant interaction between lens type and esophoria/ nonesophoria grouping. Three-way analysis of variance showed a statistically significant decrease of AC/A ratio over all five visits; there was no interaction of visit by lens or visit by phoria grouping.

CONCLUSIONS

Although there were no statistically significant differences between esophoric and nonesophoric subjects, there was only 46% as much myopia progression in the progressive lenses-esophoric group as in the progressive lenses-nonesophoric group. In addition, there were no differences in AC/A ratio between esophoric and nonesophoric subjects. However these findings are not definitive. This experiment was not designed to discriminate between refraction and oculomotor changes in esophoric and nonesophoric subjects and lacked the necessary statistical power to do so.

[Anisometropia and presbyopia: prescription of progressive lenses, a new approach]

OBJECTIVE OF THE STUDY

To show that anisometropia does not absolutely preclude the prescription of progressive lenses.

MATERIALS AND METHODS

Forty-one anisometropes and presbyopes were selected for a prolonged trial of visual correction using progressive lenses. The congenital or acquired type of their anisometropia and its particular form were also studied. Each patient was submitted to a protocol comprising of a series of ophthalmologic and orthoptic tests so as to evaluate the patient's subjective far and near refraction, with measurement of phorias and of horizontal and vertical ductions, visual acuity, and the quality of binocular vision while looking in different directions. A preliminary trial of correction in actual situation was done in order to check fusion in near vision. The entire range of tests was repeated two months after the patient was provided with the lenses. The tolerance for progressive lenses during the different activities of daily life was evaluated after the second and the sixth months.

RESULTS

Seven patients presenting an associated strabismus were not provided with the lenses because the initial pre-lens trial revealed a total inability to read within the near-vision zone. Among the 34 patients provided with the lenses, 21 constantly wore their progressive lenses and said that they were satisfied, 6 wore their progressive lenses during daily activities but preferred to use their unifocal lenses for prolonged reading, and 7 abandoned their progressive lenses because they could not tolerate them. Association with a strabismus is not synonymous with an initial impossibility or with abandonment because of the 27 patients who constantly wore their progressive lenses 9 were strabismic. The best results were obtained in the age range of 45 to 52 years old, for visual acuity for > 20/40, and in cases of congenital anisometropia with intermittent or permanent unilateral neutralization. On the other hand, patients presenting an acquired anisometropia, particularly postoperative, proved to be poor candidates.

CONCLUSION

Weak and strong anisometropia does not absolutely preclude the prescription of progressive lenses except for certain strabismic subjects with an abnormal lateral-oriented posture.