Treating diabetic retinopathy Treating diabetic retinopathy is a critical aspect of preserving vision and maintaining the overall quality of life […]
Purpose.
Volume scotomas are three-dimensional regions of space that are not visible to the observer. Volume perimetry maps volume scotomas. Volume scotomas predicted from combining monocular visual fields assume known fixation locus (mainly foveal). However, fixation loci are not always known, especially with central field loss (CFL). Here we demonstrate methods for measuring and calculating volume scotomas and discuss their practical implications.
Methods.
Three patients (bitemporal hemianopia, binasal scotoma, and CFL) were evaluated. Slices through the volume scotomas were measured at three distances: at the plane of fixation, at a plane anterior to fixation (representing anterior volume perimetry), and at a plane posterior to fixation (representing posterior volume perimetry). For anterior volume perimetry, patients fixated on a screen 100 cm away through a beamsplitter that reflected the perimetric stimulus (at 50 cm). For posterior volume perimetry, patients fixated on a near target (50 cm), while perimetric stimuli were presented on a screen 150 cm beyond fixation. At the plane of fixation, monocular visual fields under binocular viewing conditions were measured using a computerized dichoptic perimeter.
Results.
Posterior and anterior volume scotomas were documented in patients with bitemporal hemianopia and binasal scotomas, respectively. The CFL patient demonstrated both anterior and posterior volume scotomas. Scotoma magnitude was considered to determine its effect on visual function.
Conclusions.
Direct measurement of volume scotomas can be performed. Anterior and posterior volume visual fields can vary substantially from conventional binocular perimetry measured at the fixation plane, revealing blind areas not otherwise identified. These volume scotomas are likely to impair functional vision such as driving (for bitemporal hemianopes) and near work with small hand tools (for binasal scotomas). Patients with CFL will have impaired functional vision for both distance and near tasks. Consideration of volume scotomas can help provide more effective vision rehabilitation and counseling.
At Amplify with Dr Wernick I was seeking help for seemingly intractable, probably age-related dryness. I've seen other doctors about it, and that has been helpful, but what he explained to me about it and the careful way he answered all my questions gave me so much more of a clear understanding of what is going on (and is not) that I am more able to implement all his and others' recommendations than I was before. And he gave me additional resources for further follow-up. I am most grateful.
Wow! This is a great Eye Care medical facility. I was thoroughly examined by Dr. Pinkhasov for over 2 hours. She made sure to check my eyes for pretty much everything and patiently explained proper care for my eyes. They definitely know how to provide great care and treat their patients right. Now I know why they have such a great reputation and been around for so long.
Dr. Kavner is a gifted diagnostician and orthoptic therapist. He treated me several decades ago for a condition similar to dyslexia. I was having migraines five times per week. I worked with him for about a year and I experienced tremendous improvement (down to 3-4 per year) that has lasted.
Dr. Kavner recommended two types of eye therapy for my daughter. One of them using bio-feedback. In just three sessions she is seeing considerably better. She shouted this morning: Ooh my God! I could not see these letters with my glasses on, and now I can see them without my glasses. If you are willing and able to invest in improving your vision, this is a good place to go to!
Dr. Kavner recommended two types of eye therapy for my daughter. One of them using bio-feedback. In just three sessions she is seeing considerably better. She shouted this morning: Ooh my God! I could not see these letters with my glasses on, and now I can see them without my glasses. If you are willing and able to invest in improving your vision, this is a good place to go to!
I have always found Dr Kavner's work, expertise and wisdom of the highest caliber. As one of the fathers of OT, occupational othomology, his depth and breadth of knowledge about the eyes' health and wellbeing of the patient is exemplary. Cannot say enough good things about him.
Treating diabetic retinopathy Treating diabetic retinopathy is a critical aspect of preserving vision and maintaining the overall quality of life […]
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