Category Archives: Ophthalmologist

Ophthalmologists Discuss Methods to Help Physicians See What Patients Can’t See (part 9)

Glaucoma Detection When the answers to those questions are ironed out, Day says she is hopeful that the procedure is simple enough, and that the equipment is common and inexpensive enough, that it could be used as a screening device in the pediatrician’s or other primary-care physician’s office. A screening device like this would be a great improvement over the traditional devices like the Snellen chart, … Continue reading

Ophthalmologists Discuss Methods to Help Physicians See What Patients Can’t See (part 8)

The study found that, “with cycloplegia, the sensitivity of the photorefractor is quite high (greater than 80%) for errors as small as 0.75 to 1.0 D [diopters]. Sensitivity is 95% for the 1.0 to 2.0 D range. In fact, all errors larger than 1.5 D produced a measureable crescent.” Those results, Day says, indicate that, while photorefraction by itself does not measure visual acuity, their … Continue reading

Ophthalmologists Discuss Methods to Help Physicians See What Patients Can’t See (part 7)

Day gets the child’s attention with a small blinking toy that can be held either by the photographer or an assistant. Making sure the child is looking in the right direction is not a problem, she says, because the toy is an effective attention grabber. An off-axis gaze is usually either readily apparent to the photographer or by looking at the picture. If the child … Continue reading

Ophthalmologists Discuss Methods to Help Physicians See What Patients Can’t See (part 6)

Day, director of Pediatric Ophthalmology Units, Pacific Presbyterian Medical Center and Smith-Kettlewell Engineering Center For Low Vision and Blindness, San Francisco, is purposely having infants look directly at a camera and taking a flash photograph. When the pictures are processed, the pupils have that eerie red glow that often ruins home photos.

Ophthalmologists Discuss Methods to Help Physicians See What Patients Can’t See (part 5)

Contrast sensitivity testing also seems to pick up visual defects in certain disorders that are not apparent with visual acuity testing. In some cases, foveal contrast sensitivity may be impaired while visual acuity is intact. Patients with multiple sclerosis may have reduced contrast sensitivity even though their acuity is unaffected (Ann Neurol 1979;5:40-47). And, Bodis-Wollner says he has observed that without clear-cut retinopathy may have … Continue reading

Ophthalmologists Discuss Methods to Help Physicians See What Patients Can’t See (part 4)

But, more importantly he says, in a study of 35 patients who all complained of blurred vision, he found that often different patients with the same visual acuity will each score very differently on the contrast-sensitivity test (Brain 1976;99:695-710). Thirty-one of the 35 patients in that study had a “profound” change in contrast sensitivity without corresponding changes in conventionally measured visual acuity. “Our findings established … Continue reading

Ophthalmologists Discuss Methods to Help Physicians See What Patients Can’t See (part 3)

The results of his work so far, he says, lead him to believe that contrast sensitivity testing may prove to be a better, more precise way to measure visual function than the traditional Snellen chart. He also says it may be helpful in differential diagnosis, for instance, between macular and optic nerve diseases, though the exact connections between lesions and specific contrast sensitivity deficits are … Continue reading

Ophthalmologists Discuss Methods to Help Physicians See What Patients Can’t See (part 2)

Since then, he has been examining patients who complain of visual abnormalities , such as blurred vision, but have normal visual acuity. He now takes the position that “contrast sensitivity is a more accurate and comprehensive measure of vision than visual acuity,” and that contrast-sensitivity testing is an important adjunct to the traditional visual examination methods. Bodis-Wollner discussed his work and findings at the Ninth Annual … Continue reading

Ophthalmologists Discuss Methods to Help Physicians See What Patients Can’t See (part 1)

IN THE SUMMER of 1966, Ivan Bodis-Wollner, a medical student on vacation from the University of Vienna, went to Budapest to visit his uncle. The uncle was complaining of deteriorating vision. But a visual acuity test indicated that his vision had not undergone any change. Later than summer, Bodis-Wollner, concerned about the complaint, convinced his uncle to see a neurologist . That neurologist discovered a brain … Continue reading