Focal Cognitive Syndromes

The neurologic results of cortical lesions reflect the structural properties of the affected region. Lesions affecting primary sensorimotor cortices result in primary sensorimotor deficits that are qualitatively all-or-nothing, such as blindness (hemianopia) and paralysis (hemiparesis). Quantitatively, though, the severity of the deficit depends on the extent of the lesion (so that a hemiparetic patient may not be completely paralyzed but simply weak). Lesions affecting modality-specific association regions result in conceptually more complex disorders that are confined to a single modality, such as nonfluent aphasia (a form of motor speech disorder reflecting the language-dominant hemisphere) or prosopagnosia (a visual disorder impairing the ability to disambiguate visually similar entities, specifically faces, reflecting the “what” visual pathway in inferotemporal cortices).

Hysterical Visual Loss and Malingering - Diagnostic Dilemma for an Ophthalmologist

BACKGROUND Attenuation of vision may be due to underlying organic condition or due to functional visual disorder or malingering if secondary gain is associated. Causes of pathological vision loss include advanced primary open angle glaucoma, hereditary macular dystrophies and optic neuropathies. Problem in establishing diagnosis is faced where superimposition of organic and functional visual loss is there. Distinction between functional visual loss and pathological visual loss is made by thorough and careful examination of the patient by applying basic rules and tools of ophthalmology in which examining surgeon is well versed, but patient is unaware. During routine practice, every ophthalmologist encounters patients with nonorganic vision loss. The purpose of the article is to demonstrate how to distinguish between normal visual function without missing any organic visual loss. Examination of such patients requires number of tests including baseline visual acuity, pupillary reactions, slit lamp examination of anterior segment, fundus examination, visual field analysis, optical coherence tomography, visual evoked potential and electroretinography. By proving integrity and functioning of visual system, diagnosis of functional visual loss can be confirmed. Once the conclusive diagnosis is established, it is to be revealed with caution to the patient/patient’s attendant as it can lead to medico legal issues. Here, we present series of cases who presented to us in a tertiary care center of North India during a period of six months in the year of 2019 where case 1 and case 2 presented with decreased vision due to underlying pathological condition, case 3 presented with reduced vision due to functional visual disorder. Case 4, 5 and 6 provided decisive evidence of malingering. KEY WORDS Fogging, Hysterical Visual Loss, Malingering, Menace Reflex, Optokinetic Nystagmus.

Combined Interventions for Nonorganic Visual Loss in a Case with Pseudo-Myopia: A Perspective from Vietnam

A previously healthy 10-year-old girl developed painless visual loss. She was diagnosed with a spasm of accommodation confirmed by cycloplegic refraction. She was prescribed low-dose atropine and again reported acute visual loss that was inconsistent with the level of daily function. She was referred to a pediatric psychiatrist with suspicion for a nonorganic visual disorder and was diagnosed with conversion disorder. She received psychotherapy and continued the treatment with low-dose atropine. Her visual acuity at distance returned to normal. Psychogenic visual loss can mimic organic disorders; hence, ophthalmologists should be aware of cases without the agreement between visual signs and daily manifestation.

Survey on Convolutional Neural Network Based Efficient Automated Detection of Micro Aneurysm in Diabetic Retinopathy

Diabetic Retinopathy (DR) is that the most typical explanation for visual disorder of the attention depends upon polygenic disorder. For this reason, early detection of diabetic retinopathy is of crucial importance. The primary sign of diabetic retinopathy within the membrane is that the presence of the micro aneurysms (MAs) that cause due to injury within the membrane as a long abnormality impact results in diabetic mellitus. Despite many makes an attempt, automated detection of micro aneurysm from digital body structure pictures still remains to be associate open downside. Early identification of the micro aneurysms (MAs) helps us to cut back and forestall diabetic retinopathy at the first stage. Diabetic Retinopathy (DR) could be a complication of polygenic disorder and a number one explanation for visual disorder within the world. It happens once polygenic disorder damages the little blood vessels within the membrane. If the blood vessels within the membrane get harm they develop a balloon like swelling referred to as micro aneurysms. The detection of micro aneurysms (MAs) in color body structure pictures remains associate open issue within the medical image process because of the low availableness of reliability. The most two sorts of diabetic retinopathy are Non-Proliferate Diabetic Retinopathy (NPDR) and Proliferate Diabetic Retinopathy (PDR). Picture analysis by trained people, which may be an awfully pricey and time intense task because of the massive diabetic population.

The Effect of Sports on Perceived Quality of Life of People with Visual Disability

A prática esportiva melhora a qualidade de vida de pessoas com diferentes características, mas ainda não há informações sobre o impacto do esporte na qualidade de vida de pessoas com deficiência visual. O objetivo deste estudo foi identificar a percepção da qualidade de vida de atletas cegos de futebol de cinco e de goalball e compará-la com a qualidade de vida percebida de pessoas com deficiência visual fisicamente inativas. Trinta e sete homens com deficiência visual, separados em três grupos: 12 atletas de futebol de cinco (idade: M = 27,3 anos, DP = 10,2), 13 atletas de goalball (idade: M = 30,3 anos, DP = 7,0) e 12 pessoas fisicamente inativas (idade: M = 25,3 anos, DP = 2,3), responderam ao questionário WHOQOL-Bref. Atletas com deficiência visual obtiveram maior pontuação na Qualidade de Vida Global e Saúde Geral e em todos os domínios do WHOQOL-Bref do que pessoas fisicamente inativas. Não houve diferença entre a qualidade de vida percebida dos atletas de futebol e de goalball. Portanto, a despeito do tipo de esporte, sua prática está relacionada a uma melhor qualidade de vida de pessoas com deficiência visual.Palavras-chave: Cego. Futebol de Cegos. Futebol de Cinco. Goalball. WHOQOL-Bref.AbstractSports practice improves quality of life of people with different characteristics, but there is still no information about the impact of sport on quality of life among people with visual disorder. The aim of this study was to identify the perceived quality of life of blind football and goalball athletes and to compare it to perceived quality of life of physically inactive people with visual disorder. Thirty seven men with visual disorder, separated into three groups: 12 blind football athletes (age: M = 27.3 years, SD = 10.2), 13 goalball athletes (age: M = 30.3 years, SD = 7.0) and 12 physically inactive people (age: M = 25.3 years, SD = 2.3), answered the WHOQOL-Bref questionnaire. Athletes with visual disorder obtained a higher score in the Overall Quality of Live and General Health and in all domains of the WHOQOL-Bref than physically inactive people. There was no difference between the perceived quality of life of football and goalball athletes. Therefore, despite the type of sport, its practice is related to a better quality of life of people with visual disorder.Keywords: Blind. Blind Football. Football Five-a-side. Goalball. WHOQOL-Bref.

Prevalensi Penurunan Visus pada Siswa Berkebutuhan Khusus di SLB Kasih Angelia Kota Bitung Tahun Ajaran 2017/2018

Untreated visual disorder can result in mild to severe visual problems, and even blindness. This study was aimed to determine the prevalence of decreased visus in students with special needs in SLB Kasih Angelia Bitung of academic year 2017/2018. This was a descriptive prospective study. There were 61 students with special needs in this study. Of the total 61 students, 29 students had decreased vision and 32 students had normal visus. Refractive anomaly cases were higher in males versus females, and dominated by age group of 16-20 years. The prevalences of hypermetropia, astigmatism, myopia, and multiple refractive anomalies disorders were 31% (9 students), 27.6% (8 students), 20.7% (6 students), 20.7% (6 students) respectively. Conclusion: Decreased visus due to refractive anomalies were more prevalent in male students, age group of 16-20 years, and in students with deaf disability. Hypermetropia was the most common type of refractive anomalies.Keywords: decreased vision, refractive anomaly Abstrak: Gangguan penglihatan yang tidak dikoreksi dapat mengarah kelainan visus ringan sampai berat, bahkan sampai mengalami kebutaan. Penelitian ini bertujuan untuk mengetahui prevalensi penurunan visus pada siswa berkebutuhan khusus di SLB Kasih Angelia Kota Bitung tahun ajaran 2017/2018. Jenis penelitian ialah deskriptif prospektif. Terdapat 61 siswa berkebutuhan khusus dalam penelitian ini. Di antaranya terdapat 29 siswa yang mengalami penurunan visus (kelainan refraksi) dan 32 siswa lainnya memiliki visus normal. Kelainan refraksi lebih banyak ditemukan pada laki-laki dibandingkan perempuan dan didominasi oleh kelompok usia 16-20 tahun. Prevalensi hipermetropia, astigmatisma, miopia, dan kelainan refraksi ganda secara berturut-turut ialah 31% (9 siswa), 27,6% (8 siswa), 20,7% (6 siswa), dan 20,7% (6 siswa). Simpulan: Penurunan visus seperti kelainan refraksi lebih banyak didapatkan pada siswa laki-laki, kelompok usia 16-20 tahun, dan pada jenis kecacatan tunarungu. Hipermetropia merupakan jenis kelainan refraksi yang paling banyak ditemukan.Kata kunci: penurunan visus, kelainan refraksi

Fifteen-minute consultation—the child with a developmental disability: is there an ocular or visual abnormality?

ObjectiveTo present a structured approach for an outpatient consultation for a child with developmental disability who may have an ocular or visual disorder.MethodReview of relevant literature and description of the approach to ocular and visual assessment which could be used by any paediatrician.ConclusionA systematic approach to history, observation and examination of a child with a developmental disability will assist in identifying a possible visual problem. A structured referral letter will ensure that the child will receive the most appropriate assessment to clarify the problem and appropriate management in the eye clinic.