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Risk of cataract and glaucoma in patients with multiple sclerosis

The aim of the study was to evaluate whether multiple sclerosis (MS) is associated with risk of cataract or glaucoma. We conducted a population-based cohort study utilizing the UK General Practice Research Database (1987–2009) linked to the national hospital registry of England (1997–2008). Incident MS patients (5576 cases) were identified and each was matched to six patients without MS (controls) by age, gender, and practice. Cox proportional hazard models were used to estimate hazard ratios (HRs) of incident cataract and glaucoma in MS. Time-dependent adjustments were made for age, history of diseases and drug use.

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Risk of cataract and glaucoma in patients with multiple sclerosis

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Age related visual pathologies among nursing home residents: an evaluation of light conditions and recording in client files

The finding of poor lighting conditions in nursing homes in combination with a high prevalence of visual problems (with cataract found to be the most common age related pathology), stretches the need of enhanced awareness of eye care by professional caregivers.

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Age related visual pathologies among nursing home residents: an evaluation of light conditions and recording in client files

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Ocular straylight

Intra-ocular straylight can cause decreased visual functioning, and it may cause diminished vision-related quality of life (VRQOL). This cross-sectional population-based study investigates the association between straylight and VRQOL in middle-aged and elderly individuals. Multivariable linear regression analyses were used to assess the association between straylight modeled continuously and cutoff at the recommended fitness-to-drive value, straylight ≥ 1.4 log(s), and VRQOL. The study showed that participants with normal straylight values, straylight ≤ 1.4 log(s), rated their VRQOL slightly better than those with high straylight values (straylight ≥ 1.4 log(s)). Furthermore, multivariable regression analysis revealed a borderline statistical significant association (p = .06) between intra-ocular straylight and self-reported VRQOL in middle-aged and elderly individuals. The association between straylight and self-reported VRQOL was not influenced by the status of the intra-ocular lens (natural vs. artificial intra-ocular lens after cataract extraction) or the number of (instrumental) activities of daily living that were reported as difficult for the elderly individuals.

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Diplopie door monovisie

Doelstelling: In kaart brengen van de risicofactoren voor het ontwikkelen van binoculaire diplopie na conventionele monovisie door middel van contactlenzen of refractiechirurgie bij presbyopen. Methode: Voor deze literatuurstudie is in maart 2017 gezocht in databanken Pubmed, ScienceDirect en Google Scholar. Artikelen zijn geïncludeerd als binoculaire diplopie door monovisie wordt beschreven. Alle patiënten die worden weergegeven in deze artikelen zijn ouder dan 40 jaar en hebben monovisie door middel van contactlenzen of refractiechirurgie. De resultaten beschrijven de oorzaken van de binoculaire diplopie, de voorgeschiedenis van de patiënt met betrekking tot strabismus en de hoogte van additie. Onderscheid wordt gemaakt tussen contactlensdragers en patiënten die refractiechirurgie hebben ondergaan. Resultaten: In deze literatuurstudie zijn zes artikelen verwerkt. Uit deze artikelen zijn 35 patiënten met binoculaire diplopie meegenomen in dit onderzoek, vijftien patiënten met contactlens geïnduceerde monovisie en twintig patiënten met refractiechirurgie geïnduceerde monovisie. De oorzaken van binoculaire diplopie (decompensatie van een heteroforie, een intermitterend strabismus die constant wordt, een verworven heterotropie, decompensatie van een N IV parese en fixation switch diplopie) geven geen grote verschillen in aantal patiënten. Een additie hoger dan twee dioptrie komt meer voor in deze patiëntengroep met binoculaire diplopie dan een lagere additie. Een positieve voorgeschiedenis met betrekking tot strabismus komt meer voor dan een negatieve voorgeschiedenis. Relevante verschillen tussen contactlensdragers en patiënten die refractiechirurgie hebben ondergaan zijn niet gevonden. Conclusie: Vanwege het gebrek aan consistente data is meer onderzoek nodig voor significante resultaten.

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The machinery of life

Dit artikel gaat over kunst in de zorg.

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Design of a healthy living environment for older adults with low vision

HB2006 : proceedings of the 8th international conference healthy buildings. Oliveira Fernandez, E. de; Gameiro da Silva, M.; Rosada Pinto, J. (red). ISBN 989-95067-1-0 2006 4-8 juni, Lissabon, Portugal, volume III, p. 279-282

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Design of a healthy living environment for older adults with low vision

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The TeleTriageTeam, Offering Continuity of Personalized Care Through Telemedicine: Development and Evaluation

Background: The COVID-19 pandemic taught us how to rethink care delivery. It catalyzed creative solutions to amplify the potential of personnel and facilities. This paper presents and evaluates a promptly introduced triaging solution that evolved into a tool to tackle the ever-growing waiting lists at an academic ophthalmology department, the TeleTriageTeam (TTT). A team of undergraduate optometry students, tutor optometrists, and ophthalmologists collaborate to maintain continuity of eye care. In this ongoing project, we combine innovative interprofessional task allocation, teaching, and remote care delivery. Objective: In this paper, we described a novel approach, the TTT; reported its clinical effectiveness and impact on waiting lists; and discussed its transformation to a sustainable method for delivering remote eye care. Methods: Real-world clinical data of all patients assessed by the TTT between April 16, 2020, and December 31, 2021, are covered in this paper. Business data on waiting lists and patient portal access were collected from the capacity management team and IT department of our hospital. Interim analyses were performed at different time points during the project, and this study presents a synthesis of these analyses. Results: A total of 3658 cases were assessed by the TTT. For approximately half (1789/3658, 48.91%) of the assessed cases, an alternative to a conventional face-to-face consultation was found. The waiting lists that had built up during the first months of the pandemic diminished and have been stable since the end of 2020, even during periods of imposed lockdown restrictions and reduced capacity. Patient portal access decreased with age, and patients who were invited to perform a remote, web-based eye test at home were on average younger than patients who were not invited. Conclusions: Our promptly introduced approach to remotely review cases and prioritize urgency has been successful in maintaining continuity of care and education throughout the pandemic and has evolved into a telemedicine service that is of great interest for future purposes, especially in the routine follow-up of patients with chronic diseases. TTT appears to be a potentially preferred practice in other clinics and medical specialties. The paradox is that judicious clinical decision-making based on remotely collected data is possible, only if we as caregivers are willing to change our routines and cognitions regarding face-to-face care delivery.

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Exploring the Impact of Natural Light Exposure on Sleep of Healthy Older Adults

Studies among people with dementia demonstrated that the sleep quality and rhythm improves significantly when people are exposed to ambient bright light. Since almost half of the healthy older people also indicate to suffer from chronic sleep disorders, the question arises whether ambient bright light can be beneficial to healthy older people. Particularly the effect on sleep/wake rhythm in relation to the exposure to natural light is the focus. It was hypothesised that the sleep quality would be worse in winter due to a lower daylight dose than in summer due to the lower illuminance and exposure duration. A field study was conducted to examine the relationship between daylight exposure and sleep quality in 14 healthy older adults living independently in their own dwellings in the Netherlands. All participants were asked to take part of the study both during the summer period as well as during the winter period. Therefore, they had to wear an actigraph for five consecutive days which measured sleep, activity and light exposure. Results confirmed that people were significantly longer exposed to high illumination levels (>1000 lx) in summer than in winter. Sleep quality measures, however, did not differ significantly between summer and winter. A significant, positive correlation was found between exposure duration to high illuminance from daylight during the day and the sleep efficiency the following night in summer, implying that being exposed to high illuminance for a longer time period has a positive effect on sleep efficiency for the individual data. There was also a tendency of less frequent napping in case of longer exposure duration to light for both seasons. Sleep quality does not differ between summer and winter but is related to the duration of the exposure to bright light the day prior to the night. CC-BY Original article at http://solarlits.com/jd/5-14 http://dx.doi.org/10.15627/jd.2018.2 https://www.dehaagsehogeschool.nl/onderzoek/lectoraten/details/urban-ageing#over-het-lectoraat

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Exploring the Impact of Natural Light Exposure on Sleep of Healthy Older Adults

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Age-related normal limits for spatial vision

Purpose: To establish age-related, normal limits of monocular and binocular spatial vision under photopic and mesopic conditions. Methods: Photopic and mesopic visual acuity (VA) and contrast thresholds (CTs) were measured with both positive and negative contrast optotypes under binocular and monocular viewing conditions using the Acuity-Plus (AP) test. The experiments were carried out on participants (age range from 10 to 86 years), who met pre-established, normal sight criteria. Mean and ± 2.5σ limits were calculated within each 5-year subgroup. A biologically meaningful model was then fitted to predict mean values and upper and lower threshold limits for VA and CT as a function of age. The best-fit model parameters describe normal aging of spatial vision for each of the 16 experimental conditions investigated. Results: Out of the 382 participants recruited for this study, 285 participants passed the selection criteria for normal aging. Log transforms were applied to ensure approximate normal distributions. Outliers were also removed for each of the 16 stimulus conditions investigated based on the ±2.5σ limit criterion. VA, CTs and the overall variability were found to be age-invariant up to ~50 years in the photopic condition. A lower, age-invariant limit of ~30 years was more appropriate for the mesopic range with a gradual, but accelerating increase in both mean thresholds and intersubject variability above this age. Binocular thresholds were smaller and much less variable when compared to the thresholds measured in either eye. Results with negative contrast optotypes were significantly better than the corresponding results measured with positive contrast (p < 0.004). Conclusions: This project has established the expected age limits of spatial vision for monocular and binocular viewing under photopic and high mesopic lighting with both positive and negative contrast optotypes using a single test, which can be implemented either in the clinic or in an occupational setting.

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Risk of cataract and glaucoma in patients with multiple sclerosis