Susac Syndrome: an uncommon cause of impaired vision

A 35-year-old Caucasian woman presented an abrupt onset of bilateral impaired vision, and arrived to our attention two weeks later. She had a previous episode of mild dizziness. She underwent a fluorescein angiography showing branch retinal artery occlusions and a brain magnetic resonance imaging (MRI) revealing several supraand infratentorial FLAIR-hyperintense white matter lesions, two with contrast enhancement. Thrombophilic, autoimmune and infective (including Human Immunodeficiency Virus, Borrelia burgdorferi, Hepatitis B Virus, Hepatitis C Virus, Herpes Simplex Virus 1-2, Varicella Zoster Virus) screening was negative. Cerebrospinal fluid analysis showed intrathecal IgG synthesis. We suspected a Primary Central Nervous System Vasculitis, and intravenous steroids were started. Three months later a second brain MRI showed seven new lesions without contrast enhancement, and she revealed a cognitive impairment and bilateral hearing loss. Reviewing the clinical history and MRI, she fulfilled diagnostic criteria for Susac syndrome. She had two cycles of cyclophosphamide, and recovered in 6 months and then remained stable with metotrexate.

Impaired vision and physical activity in childhood and adolescence: findings from the Millennium Cohort Study

Background/aimsInvestigate if impaired vision is associated with reduced levels and differences in types of physical activity (PA) to identify barriers or enablers to achieving healthy PA levels.MethodsData from the Millennium Cohort Study of children born in the UK in 2000–2001 and followed-up to age 14 years (n=11 571). Using parental report on eye conditions coded by clinicians, children were categorised as having no, unilateral or bilateral impaired vision. Outcomes included objective accelerometer-derived time spent in moderate-to-vigorous physical activity (MVPA), and 16 PA types reported by parents, teachers and/or participants, covering physical education (PE), organised sports, self-organised sports and hobbies.ResultsOverall, 50% of 7-year-olds and subsequently 41% as 14-year-olds achieved the internationally recommended level of ≥60 MVPA min/day, irrespective of vision status, and mainly attributable to PE and organised sports. Bilateral impaired vision (vs none) was associated with parent-reported difficulties with PE (adjusted OR, 4.67; 95% CI, 2.31 to 9.41), self-rated poor ability in PE (3.21; 1.44 to 7.15) and not enjoy indoor PA (0.48; 0.26 to 0.88). Unilateral impaired vision was associated with both parent-rated difficulties (1.80; 1.26 to 2.59) and teachers’ perception of low ability in PE (2.27; 1.57 to 3.28), and reduced odds of high participation in organised sports (0.77; 0.59 to 0.99). Age-related trajectories showed suboptimal PA in childhood tracked into adolescence, with no difference by vision status.ConclusionPopulation-wide programmes to increase PA levels in children should pay special attention to those with impaired vision and include early interventions to encourage participation and confidence in PE and organised sports, starting in primary school and maintained afterwards.

The Effect of Changing Colours on Central Crowding Reading

Background: Crowding can be defined as the impaired recognition of closely spaced objects. Changing colour and lighting enhance visual comfort and perceptual troubles that influence impaired vision reading. Objective: The current study was aimed to investigate the impact of changing the flanker distance and unflanked targets with colours on central crowding reading for subjects with their distant best correction (BCVA) equal to or greater than 6/6. Methodology: Six native English speakers (age: 18–38) who participated in a cross-section intervention study were asked to identify the orientation of the letter E (flanked or unflanked) in different directions around the central target in different colours (red, green, blue and black) on a white background. Results: Different colours affect central crowding (p<0.05). However, the central crowding reading of red was not affected by changing flankers (P > 0.05). Conclusion: Central reading crowding is visual crowding. Different colours affect central crowding. However, the central crowding reading in red was not affected by changes in flankers.

Decoding the ergonomics in the new normal for dentistry: A narrative review

Focus and precision are the sine qua non of dentistry, wherein the routine tasks require a peak pinch force and results in finger fatigue and cumulative trauma disorders combined with impaired vision. Dentists’ posture is treated with great care and oft repeated in Ergonomics, studied in undergraduate courses and the continuing education courses, though many still do not know the subject well enough. The study selection was done upon selecting the dental surgeons, hygienists, assistant working on their patients and included the findings relating to practice environment. The electronically searched sources until 2021 were the MEDLINE Pub med, EMBASE, Wiley Online Library, Science direct, American Dental Association (ADA) website and Google Scholar. An additional manual search and queries with cross-reference yielded around fifty studies ultimately. The International Ergonomic Association (IEA) recognized certain domains long ago and its noteworthy application for dental office is set forth in the present review. Ergo-dentistry may come to be realized as a new essential in the new normal for our profession. Evidence echoes that dentists are at risk for developing health problems, particularly the musculoskeletal disorders and impaired vision. Beyond doubt, a healthy dentist is a pre-requisite for a successful dental practice. Ergodontics is the key to keep check on the same and following its core principles is essential.

Geriatric Conditions and Functional Disability among a National Community-Dwelling Sample of Older Adults in India in 2017–2018

This study aimed to determine the prevalence of geriatric conditions and their association with disability in older community-dwelling adults in India. The cross-sectional sample consisted of 31,477 individuals (≥60 years) from the Longitudinal Ageing Study in India (LASI) Wave 1 in 2017–2018. Geriatric conditions assessed included injurious falls, impaired cognition, underweight, dizziness, incontinence, impaired vision and impaired hearing. More than two in five participants (44.3%) had no geriatric condition, 32.7% had one, 15.9% two and 7.1% had three or more geriatric conditions; 26.9% were underweight, 14.5% dizziness, 13.7% had impaired vision, 9.6% impaired hearing, 9.3% impaired cognition, 8.2% major depressive disorder, 5.7% injurious falls, 4.0% incontinence, and 7.4% had Activity of Daily Living (ADL) dependencies. In logistic regression analysis, adjusted by sociodemographic factors and the number of chronic conditions, we found a higher number of geriatric conditions, and a higher number of chronic conditions were associated with ADL dependencies. In a model adjusted for sociodemographic factors and the type of chronic conditions, we found that a higher number of geriatric conditions and heart disease, stroke, and bone or joint disorder were positively associated with ADL dependencies. The odds of ADL dependencies increased with impaired cognition, impaired vision, impaired hearing, and major depressive disorder. Impaired cognition, incontinence, impaired vision and major depressive disorder were positively associated with dressing, bathing, eating, transferring, and toileting dependency. In addition, impaired hearing was associated with transferring and toileting dependency. More than half of older adults in India had at least one geriatric condition. The prevalence of geriatric conditions was as high as the prevalence of chronic conditions, which in some cases were associated with disability. Geriatric conditions should be included in health care management.

Impaired Vision Function Due to Use of Gadget

Background: The disruption of the visual function resulting from the use of gadgets, by explaining the disturbance of the visual function that occurs and the proper and correct use of gadgets, which can maintain vision function, especially for children and adolescents Method: SLiterature sources were searched using data bases: Google Scholar, Pubmed, Proquest, Science Direct, and Sinta using keywords: computer, gadget, portable display, smartphone and eye, myopia, vision, visual. With boolen operators (AND, OR, NOT). The articles obtained were published between January 2015 and October 2020 for selection according to the objectives of the literature review and obtained as many as fifteen studies included in this literature review. Result: Prolonged use of gadgets and the like was significantly associated with decreased visual acuity and the onset of myopia (8 studies), as well the occurrence of one or more Computer Vison Syndrome in the eye organs (7 studies). Conclusion: The use of gadgets is not the only main cause of health problems, but contributes significantly to various health problems, especially impaired vision, namely decreased visual acuity, myopia, and computer vision syndrome. Proper management of gadget usage can prove beneficial in understanding education and other fields better whereas excessive use can lead to various health problems.