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Purpose: To study the relationship between lens opacity and intraocular straylight, visual acuity and contrast sensitivity.
Methods: We investigated 2422 drivers in five clinics in different European Union (EU) member states aged between 20 and 89 years as part of a European study into the prevalence of visual function disorders in drivers. We measured visual acuity [Early Treatment Diabetic Retinopathy Study (ETDRS) chart], contrast sensitivity (Pelli–Robson chart) and intraocular straylight (computerized straylight meter). Lens opacities were graded with the Lens Opacities Classification System III (LOCS) without pupillary dilation. Participants answered the National Eye Institute Visual Functioning Questionnaire – 25.
Results: Intraocular straylight was related more strongly to LOCS score than to both visual acuity and contrast sensitivity. Visual acuity and contrast sensitivity were correlated to each other well, but to intraocular straylight to a much lesser extent. Self‐reported visual quality was best related to contrast sensitivity; night driving difficulty was best related to visual acuity.
Conclusion: Straylight is found to have added value for visual function assessment in drivers, whereas if visual acuity is known contrast sensitivity has limited added value.
The compensation comparison (CC) method is a psychophysical technique to measure retinal stray light. It uses a two alternative forced choice (2AFC) measurement paradigm. The 25 binary (0 and 1) responses resulting from the 2AFC test are analyzed using maximum likelihood estimates. The likelihood function is used to give two quantities: the most likely stray-light level of the eye under investigation, and the accuracy of this estimate [called expected standard deviation (ESD)]. The CC method is used in 2422 subjects of the GLARE study. Each eye is tested twice to allow analysis of measurement repeatability. Furthermore, the large amount of responses is used to evaluate the shape of the psychometric function, for which a mathematical model is used. The shape of the psychometric function found by averaging the 0 and 1 responses fit well to the model function. Data sorted according to ESD show differences in the shape of the psychometric function between good and bad observers. These different shapes for the psychometric function are used to reanalyze the data, but the stray-light results remain virtually identical. ESD proves to be an efficient tool to detect unreliable measurements. In clinical practice, ESD may be used to decide whether to repeat a measurement.
We investigated spontaneous variation of binocular torsion. Variation was expressed as SD of torsional eye positions measured over periods up to 32 sec. Subjects viewed a single dot target for periods of 32 sec. In half of the trials a large random-dot background pattern was superimposed on the dot. The movements of both eyes were measured with scleral induction coils. Spontaneous torsional movements were largely conjugate: cyciovergence was much more stable than cycloversion. This difference was not due to roll head movements. Stability of cyclovergence was improved by the background pattern. Although overall stability (SD of position) of cycloversion was unaffected by a background, the background induced or enhanced a small-amplitude torsional nystagmus in 3 out of 4 subjects. We hypothesize that the difference in stability of cycloversion vs cyciovergence reflects the greater importance of torsional retinal correspondence, compared to absolute torsional position. In two subjects we found evidence for the existence of cyclophoria, manifested by systematic shifts in cyclovergence caused by the appearance and disappearance of the background.
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