Optometry and vision science : official publication of the American Academy of Optometry
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Comparative Study
The second version of the L. V. Prasad-functional vision questionnaire.
The L. V. Prasad-Functional Vision Questionnaire (LVP-FVQ) was developed using Rasch analysis to assess self-reported difficulties in performing daily tasks in school children with visual impairment (VI) in India. However, the LVP-FVQ has psychometric problems of inadequate measurement precision and lack of detailed assessment of dimensionality. Furthermore, items pertaining to use of technology are lacking. The aim of this study was to present the development and validation of the second version of LVP-FVQ (LVP-FVQ II). ⋯ Given the superior measurement properties and the interval-level scores, the LVP-FVQ II appears to offer advantages over LVP-FVQ in assessment of difficulties in performing daily tasks in this population. It can be adapted for use in other developing countries.
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Dissociated horizontal deviation (DHD), a rare subtype of strabismus, is a change in horizontal eye alignment that does not obey Hering’s law. The variation is unrelated to a change in accommodation and depends on which eye is fixating. Both esotropia (ET) and exotropia (XT) can manifest in the same patient with DHD. Surgery has been reported to manage DHD, but often a second or third surgery is necessary. We report two cases of DHD that were managed with vision therapy (VT). ⋯ In two DHD cases, control of eye alignment improved with VT. To the best of our knowledge, these are the first case reports to describe management of DHD with VT. Eye care practitioners should be aware that a long period of VT may be necessary to successfully manage DHD.
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Medical decision making has evolved from a paternalistic, "doctor knows best system" to one of shared decision making between health care providers and patients. Shared decision making involves informed consent related to the proposed health care options and medical decision-making capacity by patients. Adults aged 90 and older are the fastest growing segment of the US population. Dementia prevalence increases dramatically among this group. Dementia may affect the ability of patients to participate in shared decision making. ⋯ The case of a 91-year-old female rehabilitation inpatient with mild cognitive impairment, cataracts, and macular degeneration is presented. The case highlights key issues of informed decision making and medical decision-making capacity related to cataract surgery. Video examples of the assessment of cognitive and medical decision-making capacity are presented.