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Diagnostics
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Visual Impairment: Diagnosis and Management
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Visual Impairment: Diagnosis and Management

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: closed (28 February 2025) | Viewed by 9678

Special Issue Editor

Prof. Dr. James Vernon Odom

E-Mail Website
Guest Editor
1. Department of Ophthalmology and Visual Sciences, West Virginia University, Morgantown, WV, USA
2. Department of Neuroscience, West Virginia University, Morgantown, WV, USA
Interests: low vision; blindness; visual impairment; assessment of visual dysfunction

Special Issue Information

Dear Colleagues,

Visual impairment ranges from uncorrected refractive errors to genetic disorders to age-related vision loss from diabetes, glaucoma, and age-related macular degeneration. This Special Issue aims to explore both the diagnosis and management of the full range of visual impairments. Reviews and experimental studies will be considered. Case reports will not be accepted. All submissions will be subject to peer review. 

Diagnostic methods include, but are not limited to:

  • Behavioral assessment including visual acuity;
  • Imaging of the visual system;
  • Electrophysiological assessment of the visual system;
  • Questionnaires to assess the patient's vision. 

Management of visual impairment includes, but is not limited to:

  • Behavioral training of sensory or motor systems to compensate for loss;
  • Biochemical approaches to delay, halt, or reverse visual changes;
  • Development and training in the use of devices to improve function. These include:
    • Classic optical devices;
    • Electronic aids;
    • Sensory substitution methods.

Prof. Dr. James Vernon Odom
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • visual impairment
  • low vision
  • vision loss
  • diagnosis
  • visual dysfunction

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (6 papers)

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Research

13 pages, 1041 KiB  
Article
Quantitative Analysis of Early Retinal Changes and OCT Parameters in Diabetic Subjects with and Without Retinopathy
by Sulaiman Aldakhil, Naveen Challa, Saja A. Alhoshan, Foziyah Abohaimed, Bashair N. Alnasser, Hana A. Almuhawas, Saif AlObaisi and Saif H. Alrasheed
Diagnostics 2025, 15(4), 451; https://doi.org/10.3390/diagnostics15040451 - 13 Feb 2025
Viewed by 489
Abstract
Aim: The aim of this paper is to assess the changes in optical coherence tomography angiography (OCTA) parameters among normal individuals and for type 2 diabetes mellitus (DM) patients, with and without retinopathy, in the adult Saudi population. Methods: This was a [...] Read more.
Aim: The aim of this paper is to assess the changes in optical coherence tomography angiography (OCTA) parameters among normal individuals and for type 2 diabetes mellitus (DM) patients, with and without retinopathy, in the adult Saudi population. Methods: This was a prospective cross-sectional study; subjects were divided into four groups. Group 1, the control group, consisted of 40 eyes from normal healthy individuals, while the other three groups included subjects diagnosed with type 2 DM at various stages of retinopathy. All subjects’ OCT and OCTA images were acquired using a swept-source OCT (DRI Triton, Topcon, Inc., Tokyo, Japan). Parameters collected included superficial capillary plexus (SCP) vessel density (VD), foveal avascular zone (FAZ), macular thickness (MT), ganglion cell layer (GCL) thickness, and retinal nerve fiber layer (RNFL) thickness at central and perifoveal locations. OCTA acquisition included a 4.5 × 4.5 mm scan to measure FAZ and SCP VD, with the FAZ manually mapped onto OCTA images at the SCP. Results: There was a significant decrease in SCP VD (p < 0.05) in all quadrants except the central as the severity of diabetes increased. SCP VD was considerably lower in DM patients without retinopathy compared to controls. Additionally, the FAZ area exhibited a significant increasing trend as the severity of diabetic retinopathy (DR) increased. Regression analysis showed a significant decrease in RNFL thickness (p < 0.01) and GCL thickness (p < 0.01) in the nasal quadrant as DR severity increased, even after adjusting for age, gender, and mean arterial pressure. Furthermore, SCP VD showed a significant negative correlation with both the duration of DM and contrast sensitivity. Conclusions: OCT and OCTA parameters were significantly different between the control and diabetic patients with and without DR. The observed microvascular and contrast sensitivity alterations may precede detectable DR damage or changes in visual acuity. Full article
(This article belongs to the Special Issue Visual Impairment: Diagnosis and Management)
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23 pages, 258 KiB  
Article
Development of a Children’s Visual Function Quality of Life (CVF-QoL) Instrument for Rural School-Going Children with Visual Impairments Within a South African Context: Item Generation and Validation
by Tshubelela Sello Simon Magakwe, Rekha Hansraj and Zamadonda Nokuthula Xulu-Kasaba
Diagnostics 2025, 15(3), 331; https://doi.org/10.3390/diagnostics15030331 - 30 Jan 2025
Viewed by 723
Abstract
Background: Assessing visual function and quality of life in children with visual impairments is crucial for understanding its impact and evaluating interventions. While tools exist for developed countries, there is a lack of instruments for rural school-going children in middle- to low-income [...] Read more.
Background: Assessing visual function and quality of life in children with visual impairments is crucial for understanding its impact and evaluating interventions. While tools exist for developed countries, there is a lack of instruments for rural school-going children in middle- to low-income countries. This study aimed to develop and validate an instrument to measure Children’s Visual Function Quality of Life (CVF-QoL) for South African children aged 6 to 17 with uncorrected refractive errors, visual impairments, or blindness. Methods: The CVF-QoL instrument was created through a literature review and focus group discussions with experts and children. Readability was assessed, resulting in two versions of the CVF-QoL instrument. The contents of both versions were validated by experts, and pre-testing was performed with school children aged 6–17 years. Results: From the literature review, 769 items were identified, and 477 statements were generated from focus group discussions. After merging and eliminating duplicates, 91 items were classified into eight domains. The tool was divided into Version 1.1 for ages 10–17 (89 items) and Version 2.1 for ages 6–9 (63 items), both demonstrating strong clarity, coherence, and relevance. Conclusions: The CVF-QoL instruments are valid for evaluating the quality of life-related to visual function among rural school-going children with visual impairments in South Africa. This instrument thus provides an additional QoL tool to those already existing that may be more appropriate for measuring quality of life for rural school-going children in low- and middle-income countries. Full article
(This article belongs to the Special Issue Visual Impairment: Diagnosis and Management)
14 pages, 4232 KiB  
Article
Are Optometrists Prepared to Be Involved in Post-Stroke Rehabilitation?
by Amritha Stalin, Susan J. Leat and Tammy Labreche
Diagnostics 2024, 14(20), 2307; https://doi.org/10.3390/diagnostics14202307 - 17 Oct 2024
Viewed by 1113
Abstract
Background/Objectives: Stroke survivors often experience various visual consequences that impact their daily life and may benefit from visual interventions. However, some of these usually go unaddressed as optometrists are rarely included in the post-stroke care pathway. Yet, optometrists are interested in contributing to [...] Read more.
Background/Objectives: Stroke survivors often experience various visual consequences that impact their daily life and may benefit from visual interventions. However, some of these usually go unaddressed as optometrists are rarely included in the post-stroke care pathway. Yet, optometrists are interested in contributing to the care of these patients. This survey evaluated the readiness of optometrists in diagnosing and managing visual disorders specific to stroke survivors. Methods: A questionnaire was developed by the researchers, pilot tested by 5 research optometrists and 15 community optometrists, and modified based on the feedback. Practicing optometrists were invited to complete the anonymous online survey through optometric organizations in Canada, the US, Hong Kong, India, and the UK. Results: Most respondents displayed strong knowledge, but 61.6% indicated that enhancing their knowledge would be helpful. The majority (87%) agreed that stroke is related to an increased incidence of falls. Participants’ knowledge regarding the natural history of post-stroke visual disorders was poorer. There were also inconsistencies regarding what optometrists considered ideal interventions and what they undertook in practice. More than 50% of respondents reported that the quality of published evidence on post-stroke visual consequences was low or nonexistent. Conclusions: Overall, survey respondents displayed sufficient knowledge. However, there are areas of uncertainty in their knowledge, which in many cases correspond to real gaps in the available evidence. There is a need to identify and remediate these gaps to enable optometrists to deliver quality optometric care as collaborative members of the post-stroke professional team, which would eventually improve the rehabilitation of stroke survivors. Full article
(This article belongs to the Special Issue Visual Impairment: Diagnosis and Management)
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37 pages, 1294 KiB  
Article
Differential Functional Changes in Visual Performance during Acute Exposure to Microgravity Analogue and Their Potential Links with Spaceflight-Associated Neuro-Ocular Syndrome
by Adrian Iftime, Ioana Teodora Tofolean, Victor Pintilie, Octavian Călinescu, Stefan Busnatu and Ioana Raluca Papacocea
Diagnostics 2024, 14(17), 1918; https://doi.org/10.3390/diagnostics14171918 - 30 Aug 2024
Viewed by 1210
Abstract
Background: Spaceflight-Associated Neuro-Ocular Syndrome (SANS) is a complex pathology threatening the health of astronauts, with incompletely understood causes and no current specific functional diagnostic or screening test. We investigated the use of the differential performance of the visual system (central vs. perimacular visual [...] Read more.
Background: Spaceflight-Associated Neuro-Ocular Syndrome (SANS) is a complex pathology threatening the health of astronauts, with incompletely understood causes and no current specific functional diagnostic or screening test. We investigated the use of the differential performance of the visual system (central vs. perimacular visual function) as a candidate marker of SANS-related pathology in a ground-based microgravity analogue. Methods: We used a simple reaction time (SRT) task to visual stimuli, presented in the central and perimacular field of view, as a measure of the overall performance of the visual function, during acute settings (first 10 min) of vertical, bed rest (BR), −6°, and −15° head-down tilt (HDT) presentations in healthy participants (n = 8). We built dose–response models linking the gravitational component to SRT distribution parameters in the central vs. perimacular areas. Results: Acute exposure to microgravity induces detectable changes between SRT distributions in the perimacular vs. central retina (increased mean, standard deviation, and tau component of the ex-Gaussian function) in HDT compared with vertical presentation. Conclusions: Functional testing of the perimacular retina might be beneficial for the earlier detection of SANS-related ailments in addition to regular testing of the central vision. Future diagnostic tests should consider the investigation of the extra-macular areas, particularly towards the optic disc. Full article
(This article belongs to the Special Issue Visual Impairment: Diagnosis and Management)
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10 pages, 1622 KiB  
Article
Reliability of Binocular Esterman Visual Field Test in Patients with Glaucoma and Other Ocular Conditions
by Shuhei Fujimoto, Kengo Ikesugi, Takako Ichio, Kohei Tanaka, Kumiko Kato and Mineo Kondo
Diagnostics 2024, 14(4), 433; https://doi.org/10.3390/diagnostics14040433 - 16 Feb 2024
Viewed by 2335
Abstract
The binocular Esterman visual field test (EVFT) of 120 points was the first method to quantify the defects in the binocular visual field. It is used in many parts of the world as a standard test to determine whether an individual has the [...] Read more.
The binocular Esterman visual field test (EVFT) of 120 points was the first method to quantify the defects in the binocular visual field. It is used in many parts of the world as a standard test to determine whether an individual has the visual capabilities to drive safely. In Japan, it is required for the grading and issuance of visual disability certificates. The purpose of this study was to determine the reliability of the EVFT results. We studied 104 patients who had undergone the binocular EVFT at Mie University Hospital. Their mean age was 68.0 ± 11.4 years, and the best-corrected visual acuity of the better eye was 0.18 ± 0.38 logMAR units. The EVFT was performed twice on the same day, and the results of the first and second tests were compared. The mean Esterman scores for the first and second test were 89.3 ± 30.5 and 89.1 ± 30.2, respectively, and the test times were 338.9 ± 86.8 and 336.7 ± 76.4 s, respectively. The differences were not significant (p = 0.69 and p = 0.33). In the Bland–Altman analyses (second–first test) of the Esterman scores, the mean difference was 0.38 without significant fixed errors (p = 0.20) or proportional errors (p = 0.27). The limits of agreement within the 1.96 standard deviation were −8.96 to +9.45 points. The agreement rate for the most peripheral 24 test points was significantly lower than the agreement rate for the other 96 test points (p < 0.01). The agreement rate of the upper visual field was significantly lower than that of the lower field (p < 0.01). The overall reliability rate of the EVFT is acceptable, but the peripheral and upper test points have relatively low reliability rates. These findings are important for interpretations of the EVFT results. Full article
(This article belongs to the Special Issue Visual Impairment: Diagnosis and Management)
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14 pages, 1424 KiB  
Article
Validation of a New Digital and Automated Color Perception Test
by Alvaro Fanlo-Zarazaga, José Ignacio Echevarría, Juan Pinilla, Adrián Alejandre, Teresa Pérez-Roche, Diego Gutiérrez, Marta Ortín and Victoria Pueyo
Diagnostics 2024, 14(4), 396; https://doi.org/10.3390/diagnostics14040396 - 11 Feb 2024
Viewed by 2849
Abstract
Although color vision deficiencies are very prevalent, there are no ideal methods for assessing color vision in all environments. We compared a new digital and automated method that quantifies color perception for the three protan, deutan, and tritan axes with two of the [...] Read more.
Although color vision deficiencies are very prevalent, there are no ideal methods for assessing color vision in all environments. We compared a new digital and automated method that quantifies color perception for the three protan, deutan, and tritan axes with two of the most commonly used color tests in daily practice: the Ishihara 38 plates test and the Farnsworth–Munsell 100-Hue test. One hundred patients underwent a triple examination composed of the new DIVE Color Test, the Ishihara test, and the Farnsworth–Munsell 100-Hue test. The DIVE Color Test was performed twice in forty participants to assess its repeatability. In the trichromatic group, the mean age stood at 20.57 ± 9.22 years compared with 25.99 ± 15.86 years in the dyschromatic group. The DIVE and Ishihara tests exhibited excellent agreement in identifying participants with color deficiency (Cohen’s kappa = 1.00), while it was 0.81 when comparing DIVE and Farnsworth. The correlation between the global perception values of Farnsworth (TES) and DIVE (GCS) was 0.80. The repeatability of the DIVE Color Test was high according to Bland–Altman analysis with an intraclass correlation coefficient of 0.83. According to Ishihara, the DIVE Color Test proved to be an effective and reproducible tool for red–green color vision deficiency detection, capable of determining the severity of the defect in each of the three axes faster and more accurately than both Ishihara and Farnsworth. Full article
(This article belongs to the Special Issue Visual Impairment: Diagnosis and Management)
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