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Purpose To characterize typical microanatomical alterations of immaturity in the fovea, that remain into childhood, after extremely preterm birth before 27 weeks gestational age (GA) and to suggest a clinical methodological evaluation tool. Methods Subjects were consecutively recruited at age 6.5 years and organized in four groups (10 subjects in each): Group A (full-term), Group B (GA 25-27 weeks) without retinopathy of prematurity (ROP), Group B* (GA 25-27 weeks) and Group C (GA 23-24 weeks) both with ROP stage 3. Foveal microanatomy was studied using a grading system of OCT-scans. Results Prematurely born children (including Group B, B* and C) had significantly reduced foveal depth (mean difference −53 μm, p < 0.001), thicker inner retinal layer (mean difference 21.6, p = 0.005) and thicker outer nuclear layer (mean difference 23.5, p < 0.001) than controls. Foveal depth and inner retinal layer thickness were significantly correlated to GA ( p = 0.003 and p = 0.017 respectively) within the preterm group. Foveal depth increased with 14.1 μm per week between GA 23 and 27. The three hyper reflective bands of the outer segments as well as a central protuberance of inner and outer segment layers were present in all children. Conclusion Previous studies have revealed signs of immaturity affecting most retinal layers at time of birth in prematurely born children. The present study adds information to which extent these signs of underdevelopment remains to later in life. The applied method showed that premature birth before GA 27 weeks commonly leads to characteristic anatomical alterations of the foveal anatomy expressed as reduced foveal depth and incomplete extrusion of the inner retinal layers. Although deviations of the outer nuclear layers can be seen in the most extremely preterm born children, the outer part of the fovea generally develops well, independent of prematurity. The single most important determinant for the degree of foveal maturation seems to be GA. [ABSTRACT FROM AUTHOR]

Purpose The purpose of our study was to establish a practical and quick test for assessing reading performance and to statistically analyse interchart and test-retest reliability of a new standardized Swedish reading chart system consisting of three charts constructed according to the principles available in the literature. Methods Twenty-four subjects with healthy eyes, mean age 65 ± 10 years, were tested binocularly and the reading performance evaluated as reading acuity, critical print size and maximum reading speed. The test charts all consist of 12 short text sentences with a print size ranging from 0.9 to −0.2 log MAR in approximate steps of 0.1 log MAR. Two testing sessions, in two different groups ( C1 and C2), were under strict control of luminance and lighting environment. Reading performance tests with chart T1, T2 and T3 were used for evaluation of interchart reliability and test data from a second session 1 month or more apart for the test-retest analysis. Results The testing of reading performance in adult observers with short sentences of continuous text was quick and practical. The agreement between the tests obtained with the three different test charts was high both within the same test session and at retest. Conclusion This new Swedish variant of a standardized reading system based on short sentences and logarithmic progression of print size provides reliable measurements of reading performance and preliminary norms in an age group around 65 years. The reading test with three independent reading charts can be useful for clinical studies of reading ability before and after treatment. [ABSTRACT FROM AUTHOR]

This study aimed to analyse the decline in visual acuity (VA) during normal ageing in two Scandinavian population samples of subjects aged ≥ 70 years and to study the age-specific decline in VA in eyes with early age-related maculopathy (ARM). We carried out a cross-sectional analysis of data pertaining to VA in the better eye in one population sample from Oulu (OU), Finland (aged 70-82 years) and a second population sample from Gothenburg (GG), Sweden (aged 82 or 88 years). The change in VA with age was evaluated in healthy eyes (OU, n = 119; GG, n = 40) and in eyes with early ARM (OU-ARM, n = 22; GG-ARM, n = 114) using linear regression or logistic regression. The results were compared with those of previous reports. Our population samples showed a significant decrease with age in VA in healthy eyes in subjects aged ≥ 44 years using both statistical models. Comparisons with previous reports demonstrated a homogeneity in the decline in VA with age. On average, 0.3 logMAR are lost from middle age up to 88 years, presumably as a result of physiological ageing. In early ARM, the rate of age-specific decline in VA more than doubled and the prevalence of VA < 0.5 markedly increased. Visual acuity in healthy eyes declines with age from middle age onwards. The decrease in VA possibly accelerates in subjects aged > 70 years, although no significant evidence for this was found. An age-specific decline in VA is shown in eyes with early ARM. These results are important for the evaluation of age-specific treatment results. [ABSTRACT FROM AUTHOR]

Purpose: To study the long-term visual outcome and the age at which final visual acuity can be predicted in a population sample of children treated surgically for bilateral dense congenital cataract before 37 weeks of age. In addition, we assessed the influence of associated risk factors and compared the visual development of these aphakic children with presumably blocked visual input before early surgery to that of normal children in Sweden. Methods: The 18 patients included were followed for at least 10 years postoperatively. The median age at last visit was 15.5 years (range 10-18). The bestcorrected visual acuity (BCVA) was tested monocularly with a logarithmically scaled letter acuity test from 4 years of age to late teens. Other registered postoperative data were presence of manifest nystagmus, strabismus and complications. Results: The BCVA of the better-seeing eye reached a plateau at 7 years of age. Age at surgery of 80 days or less characterized the majority of cases with a logMAR ⩽ 0.3 with a threshold effect between 80 and 130 days of age. Compared to normal children in Sweden, the long-term visual outcome showed a deficit of 0.5-0.6 logMAR. Conclusion: In spite of optimized care and surgery before 9 months, the BCVA was subnormal in our population compared to healthy children. The long-term visual outcome can be predicted at 7 years of age. Screening with early detection followed by surgery before the end of the third month is important to decrease the risk of marked acuity loss. [ABSTRACT FROM AUTHOR]

The study has investigated the effect of lighting on the daily activities (ADL) of the visually impaired in their homes by comparison before and after light adjustments were made in the kitchen, hall and bathroom. It has also investigated the additional effects on the quality of life after providing task lighting in the living room. A total of 56 people were consecutively recruited from those receiving lighting adaptation help by the Low Vision Clinic in Göteborg. Ten persons did not complete the study. After medical examinations, lighting standards and psychosocial factors were charted. After lighting improvements were carried out in the kitchen, hall and bathroom, the subjects were randomly divided into two groups, an intervention and a comparison group. The task lighting in the living room was also improved for those included in the intervention group. Follow-up interviews to determine ADL and quality of life were performed 6 months after lighting adaptation. A marked effect on quality of life of the lighting in the living room was found for the intervention group. The effect on ADL of the basic lighting adaptation in kitchen, hall and bathroom for both groups was significant for tasks carried out on the working surface in the kitchen. Other activities in the kitchen and in the bathroom tended to improve but changes were not significant. The results confirm that it is possible to increase quality of life by improving the lighting conditions. [ABSTRACT FROM AUTHOR]

Abstract. Purpose: This study is part of a larger project whose aim is to evaluate the relationship between refractive errors and amblyopia. In an earlier study, we showed that there is a substantial increase in the prevalence of amblyopia among children with oblique astigmatism. To further evaluate this relationship, we examined children with astigmatisms of 1 dioptre or more and varying directions of the astigmatic axes. Methods: Two groups of astigmatic children, with oblique and orthogonal astigmatism, respectively, were selected for the study at 1 year of age via a general health screening programme. The most emmetropic axis was identified in each child and used in the study. Visual acuity (VA) was tested when the children were between 4 and 4.5 years of age. The presence of amblyopia, defined as difference in VA between the eyes of 0.1 log unit or more, and any increase in acuity following occlusion therapy were noted. Results: The angle of the astigmatic axis strongly relates to the risk of developing amblyopia. Axes ± 15 degrees from the main axes did not affect the risk of amblyopia but oblique astigmatism significantly increased the risk of developing amblyopia (p = 0.0024). Conclusions: The results accord with earlier findings that oblique astigmatism increases the risk of developing amblyopia. [ABSTRACT FROM AUTHOR]

ABSTRACT. Purpose: To investigate the longitudinal change in visual acuity (VA) in the oldest members of the elderly population, to estimate future numbers of people with visual impairments, and to estimate needs for and the effects of visual rehabilitation. Methods: In the Gerontological and Geriatric Population Studies in Gothenburg, Sweden (H 70), subjects underwent repeated eye examinations at the ages of 70, 82, 88, 95 and 97 years. Logistic regression analysis was used to estimate the probability of independent living as a function of distance VA at different ages. Results: Rates of normal VA (≥ 0.8) declined from 86% of the study group at age 70 to 7% of the study group at age 95 (0% at age 97). The incidence of VA ≤ 0.1 increased from 1.4% at age 70 to 27% (all women) at age 97. The deterioration was faster at higher ages. No statistically significant difference in best-corrected distance VA between genders was found. A substantial improvement was achieved by correcting refractive errors. There was a statistically significant correlation between distance VA and the probability of independent living at all ages except age 97. At ages 95 and 97, about 50% of the study group were able to read newspaper print with best-corrected glasses. Conclusions: The number of old people with impaired vision will increase. People aged 80 years and older should have regular eye-screening in order to preserve vision and present conditions of living. Cataract surgery and low vision rehabilitation should be offered when the subject can still benefit from it, preferably during their 80s at the latest. [ABSTRACT FROM AUTHOR]

To investigate the prevalence of and potential risk factors for ocular disorders and the effects of timing of cataract surgery from age 70–97 years. A representative population sample taken from within the Gerontological and Geriatric Population Studies (H 70) in Gothenburg, Sweden ( n = 958). All subjects underwent eye examinations at age 70 years in 1971 and subsequently at ages 82, 88, 95 and 97 years. All inhabitants of Gothenburg aged 95 and 97 years were invited to participate in the study. Decreased vision (visual acuity ≤ 0.5) was found in 20% and 80% of subjects at ages 82 and 97 years, respectively. Blood folate and physical activity at age 70 years correlated positively and body mass index (BMI) negatively to visual acuity (VA) ≥ 0.8 at ages 82 and 88 years. Smoking at age 70 years correlated to early age-related maculopathy (ARM). Cataract surgery had been performed in 40% of subjects at age 97 years. Surgery 2 years earlier led to a 15% increase in time spent with improved vision. The deterioration of vision in elderly people is a major health problem, for which ‘low’ folate status, smoking, ‘high’ BMI and low physical activity are potential risk factors. Early cataract surgery is also beneficial in very old patients. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor about hyperopia.

ABSTRACT. Purpose: To investigate the results of preschool vision screening and to evaluate new referral criteria in a Swedish city region. Prior to 1992, all children with visual acuity (VA) of less than 0.8 at the age of 4 years were referred to an eye clinic. Since 1992, those with slightly reduced VA (0.65 in each eye or 0.65 in one eye and 0.8 in the other) have been retested at 5.5 years of age and referred if their VA is less than 0.8. Methods: In a prospective study, the results of vision testing were collected for all children (n = 483) born in 1989–92 inclusive and registered at one child health centre at 4 years of age. The study also involved 123 other children scheduled for retesting at the age of 5.5 years. The results of the examinations and treatments at the eye clinic are evaluated. Results: Few of the children with slightly reduced VA who were retested at the age of 5.5 years had visual defects that required treatment. In those who were treated, the results of treatment were good. Conclusions: The new screening criteria appear to be appropriate and are recommended. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effectiveness of the Lang II stereo card as a screening test for amblyopia and/or strabismus. Methods: A total of 1046 children aged 12–13 years were examined in a field study in the Göteborg area, Sweden. In addition to the Lang II stereo card, the examination included visual acuity, cover testing, cycloplegic refraction, and inspection of the optical media and posterior pole. Results: If every incorrect subject response was considered a reason for referral, the Lang II test would have correctly identified 82% (23 subjects) of the 28 children with manifest strabismus and 38% (11 subjects) of the 29 children with amblyopia. The test failed to refer 45% (21 subjects). Of all subjects referred, 44 (63%) were found to be ophthalmologically normal. Conclusions: The Lang II stereo card is neither a reliable nor an efficient method of screening for amblyopia and/or strabismus. [ABSTRACT FROM AUTHOR]

Purpose: To establish the distribution of visual acuity and the prevalence of residual amblyopia and other ocular disorders in a vision-screened population group of 12–13-year-old children. Methods: In total 1046 children were examined in a field study in Sweden. The examination included visual acuity, stereopsis, cover testing, red reflex, refractive retinoscopy and examination of the posterior pole. In selected cases VEP was also performed. Results: Visual acuity ≥1.0 in at least one eye was present in 98% of cases. Residual amblyopia (≤0.5) was found in 1.1% of the population. Manifest strabismus was found in 2.7%. There were only a small number of ocular opacities and posterior pole abnormalities. Ocular albinism was found in 7 cases. In 15 children the cause of subnormal VA was unexplained. Conclusion: Results for visual acuity, residual amblyopia and other ocular disorders are very similar to previous Nordic, vision-screened populations. [ABSTRACT FROM AUTHOR]

Purpose: 1045 children between 12 and 13 years old were examined in a field study in the Göteborg area (Sweden). The aim of this study was to report the prevalence of refractive errors, with special attention to myopia, since there are no previous reports in Sweden about this age group. Methods: The examination included visual acuity testing and refraction under cycloplegia. Results: We found a prevalence of myopia (≥-0.5D) of 49.7% and a prevalence of bilateral myopia of 39%. In the whole population, 23.3% were considered to need glasses (≥-0.75D). We also found a prevalence of high myopia (≥-5D) in 2.5% of the children. Discussion: No statistically significant difference in myopia with respect to gender was found. The proportion of children needing glasses is considered the best indicator of the prevalence of myopia in this sample. The results confirm that this tendency towards myopisation in a teenage population in Göteborg is similar to the prevalence found in other parts of the world. [ABSTRACT FROM AUTHOR]