Master of Science, The Ohio State University, 2017, Vision Science

Visual acuity measurement has evolved very little throughout the course of its history. Few changes have been proposed and even fewer have been adopted to advance the process of measuring visual ability. One major and widely accepted advancement includes logMAR size progression (Bailey-Lovie and Early Treatment Diabetic Retinopathy Study) chart designs. Logarithmic progression allows for visual acuity measurements to be expanded over a larger range of values, and it also provides the opportunity to quantify acuity changes in terms of “lines of change”. Logarithmic progression also allows for easy letter-by-letter scoring, which is a more accurate and repeatable determination of visual acuity when compared to line-by-line scoring. Additional investigations to improve visual acuity measurement testing have aimed to increase reliability, repeatability, and efficiency. For example, computerized methods of visual acuity testing have been tested. These methods have faced several challenges. Further, adaptive psychophysical methods such as BestPEST and ZEST have been employed in some investigations to improve efficiency and accuracy of threshold visual acuity testing. Adaptive procedures manipulate testing based on previous answers and concentrate testing close to the estimated threshold to efficiently determine an accurate and reliable end point measurement of threshold. Both computer-assisted and adaptive procedures for measuring visual acuity still require investigation and improvement. Visual acuity measurement is one of the most commonly used and most important measures of visual quality and function, and is likely the most commonly used measurement in clinical optometry. Therefore, it is important for the measurement to be standardized and efficient, and its scoring to be accurate, reliable, and repeatable. This study aims to investigate test and scoring procedures in adaptive computer-assisted visual acuity. Computer-assisted VA procedures were evaluat (open full item for complete abstract)

Committee: Thomas Raasch O.D, PhD (Advisor) Subjects: Health Sciences; Optics

Master of Science, The Ohio State University, 2018, Environment and Natural Resources

For many animals, the ability to see their environment is critical to a variety of ecological needs, such as finding food and mates, communicating, and avoiding predation. However, underwater vision in aquatic organisms is strongly linked to the underlying optical properties (e.g. light intensity, spectral composition) of their surrounding habitat. Human-induced rapid environmental change (HIREC) can introduce changes to a water body and impose complications that can alter an organism's sensory environment and behavior. It is well known that the visual systems of fish can evolve to match the surrounding sensory environment. However, empirical evidence of visual trait divergence between populations that experience different levels of two globally important stressors on aquatic systems, dissolved oxygen (DO) and turbidity, is limited. Here, I use an endemic African cichlid (Pseudocrenilabrus multicolor victoriae) to test for variation in visual traits among four wild-caught populations that experience different levels of DO and turbidity, and are known to vary in a number of physiological and life history traits associated with these stressors. Additionally, I performed a laboratory component, using a 2 x 2 factorial (high/low DO/turbidity) split brood rearing experiment to understand the combined and separate effects of DO and turbidity on the visual acuity of F1 P. multicolor. Using behaviorally observed visual acuity experiments I measured the reaction distance of individual fish in clear and turbid water and compared results between the wild-caught populations, as well as between rearing treatments in the laboratory. I also measured and compared morphological features important to vision (e.g. eye and pupil diameter, axial length, brain weight, and optic lobe volume) among wild-caught fish from two populations. There was strong evidence for divergence in visual acuity between populations, with fish originating from turbid habitats having better visual acuity in tu (open full item for complete abstract)

Committee: Suzanne Gray PhD (Advisor); Pintor Lauren PhD (Committee Member); Hamilton Ian PhD (Committee Member); Chapman Lauren PhD (Committee Member) Subjects: Aquatic Sciences; Biology; Environmental Studies

Master of Science, The Ohio State University, 2018, Vision Science

Purpose: The use of bioptic telescopic spectacles (BTS) to obtain licensure for driving is currently legal in over 42 states, yet questions remain about performance and safety. The effect of BTS on sign identification distance is unknown. Previous studies reported worse ratings for lane position and steering steadiness in bioptic drivers, but were unable to report differences attributable to BTS use due to safety concerns with on-road testing. This study utilizes a driving simulator to compare sign identification performance with and without BTS use, and to compare bioptic and normally-sighted drivers. Velocity, lane position, and lane deviations are also examined. Additionally, self-ratings of quality of driving, avoidance, dependence, and driving space are examined. Methods: Bioptic drivers and controls were recruited from The Ohio State University College of Optometry. Visual acuity, contrast sensitivity, and visual field were assessed. The study was completed in a six-degree-of-freedom driving simulator equipped with a 260° curved front screen simulator with side mirror LCD displays and a screen seen through the rear-view mirror. Subjects completed a 32,000 meter straight four-lane highway course with light traffic and a speed limit of 45 mph. The main task was to press a button on the steering wheel whenever a target city name or route number road sign was confidently identified amongst distractor signs. This task was completed twice, once using the BTS and once without. Paired t-tests were used to analyze differences in sign recognition distance, velocity, lane position and steering entropy. Differences in the number and duration of lane deviations were also examined. Results: Twelve bioptic drivers and six controls participated. Mean±SD bioptic driver age was 56±17 and 55±10 for controls. Mean logMAR VA OU for bioptic drivers was 0.80±0.17 (20/125) and mean log CS was 1.48±0.16. Mean VA with telescope was 0.21±0.10 (20/32). The mean sign identification d (open full item for complete abstract)

Committee: Bradley Dougherty OD, PhD (Advisor); Thomas Raasch OD, PhD (Committee Member); Aaron Zimmerman OD, MS (Committee Member) Subjects: Ophthalmology; Optics

Doctor of Philosophy, The Ohio State University, 1981, Graduate School

Committee: Not Provided (Other) Subjects: Psychology

Master of Science, The Ohio State University, 2016, Vision Science

Purpose: Age-related macular degeneration is the leading cause of permanent blindness in developed countries.1-3 Higher levels of depression and disability and lower quality of life has been measured in this population.4-7 The purpose of this study was to measure perceived stress and it relationship to visual function in patients with AMD using the Perceived Stress Scale. Methods: Patients with AMD were enrolled during visits to a retinal specialist for evaluation of the need for treatment with intraocular anti-VEGF injection. Visual acuity was assessed using a backlit ETDRS chart and by-letter scoring. Four surveys were then administered to the patient. They included the Perceived Stress Scale (PSS), Impact of Vision Impairment survey (IVI), and the ENRICHD Social Support Inventory (ESSI), and the Center for Epidemiologic Studies Depression Scale (CES-D).Participants completed a large-print paper version of the surveys when possible, and the survey was read aloud to patients who were unable to complete it for visual reasons. Rasch analysis of PSS responses was performed using Winsteps with the Andrich rating scale model. Item fit to the Rasch model was assessed using infit iii mean square statistics. Response category functioning was assessed using category probability curves, and survey targeting for the study population was assessed by comparing Rasch item measures with person measures for all participants. Results: We had a total of 79 participants in this particular part of the study. The mean age was 81.19 with 48.1% bring female and 51.9% male. Rasch analysis showed that the PSS was valid to use in this population and measured the desired construct, stress. During our analysis we found that visual acuity in the better and worse eye were correlated with age. Age was also positively correlated with IVI results. Visual acuity in the better eye was correlated to visual acuity in the worse eye. PSS was not correlated with visual acuity in the worse or bette (open full item for complete abstract)

Committee: Bradley Dougherty O.D., PhD (Advisor) Subjects: Ophthalmology; Psychology

Doctor of Philosophy, The Ohio State University, 2013, Vision Science

Bioptic telescopic spectacles (BTS) allow people with vision impairment to obtain driving licensure even when their visual acuity does not meet normal state standards. BTS are spectacles with a small telescope implanted in one or both of the lenses. The telescope is used for brief periods during driving to spot distant targets such as road signs and traffic signals. The study described in this dissertation examines visual and demographic associations among obtaining a bioptic driving license, training and road testing results, and motor vehicle collisions in patients with low vision. The study also compares the collision rate of bioptic drivers to that of a control group of non-bioptic drivers matched on age and sex. A retrospective study of medical records was completed for patients examined for entry into the Ohio bioptic driving program at the College of Optometry at The Ohio State University over a five year period. Data were collected on visual factors, documented driver training, licensure testing results, and post-licensure driving record. No significant associations were found among visual and demographic factors and obtaining licensure after an initial vision examination. Several factors were significantly associated with the amount of training documented for candidates for licensure, including age and previous non-bioptic driving experience. The amount of training documented was associated with road testing results, but not with driving safety after licensure. Previous driving experience was also significantly associated with occurrence of motor vehicle collisions (MVC) in bioptic drivers, with drivers without previous experience having approximately 2.5 times as many collisions per year of licensure than those with previous experience. Other significant associations with MVC in bioptic drivers included age and the number of non-collision related convictions. Nystagmus was independently associated with MVC, but no other patient visual factors w (open full item for complete abstract)

Committee: Thomas Raasch (Advisor) Subjects: Biomedical Research; Health Sciences; Ophthalmology; Optics; Public Health; Public Policy; Transportation

Master of Science, The Ohio State University, 2006, Graduate School

Committee: Not Provided (Other) Subjects:

Master of Science, The Ohio State University, 2008, Graduate School

Committee: Not Provided (Other) Subjects:

Master of Arts (MA), Bowling Green State University, 1964, Psychology

Committee: Cecil M. Freeburne (Advisor) Subjects: Psychology

Master of Science, The Ohio State University, 2020, Vision Science

Purpose: This study primarily compared the test-retest reliability of the Pelli-Robson chart (PR) and Ohio Contrast Cards (OCC) amongst testers. The secondary goal of this study was to examine the impact on contrast sensitivity if the testing distance for the Pelli-Robson chart were to be changed. An additional goal was to evaluate the relationship between visual acuity (VA) and contrast sensitivity (CS) when using letter-based charts and grating cards. Methods: Thirty low-vision students were tested, ranging from 7-20 years old. Each student was tested with both VA and CS tests in randomized order, which included: the Bailey-Lovie chart (BL), Pelli-Robson chart, Teller Acuity Cards (TAC), and Ohio Contrast Cards. Each student repeated both the PR chart and OCC in separate rooms, but neither the BL chart nor TAC was repeated. The PR chart was also tested at closer testing distance, based on the student's logMAR acuity from the BL chart. For the letter charts, a letter-by-letter scoring method was used. For grating cards, these were both scored as preferential looking tests. Results: The Limits of Agreement for the OCC and PR chart were +/- 0.451 and +/- 0.536, respectively. There was no statistically significant difference between tester or order of testers for the PR chart and OCC. Using the PR chart at a closer distance yielded an improvement in contrast threshold performance when compared to the standard testing distance. Students performed better on grating cards than letter charts, regardless of VA testing or CS testing. Conclusions: The Ohio Contrast Cards are a promising diagnostic tool for evaluating CS on low-vision patients and other patients who cannot be tested using letter-based charts. Clinicians using the Pelli-Robson chart for low-vision patients should consider testing closer than the standard testing distance.

Committee: Angela Brown PhD (Advisor); Bradley Dougherty OD, PhD (Committee Member); Deyue Yu PhD (Committee Member) Subjects: Health Care; Ophthalmology

Master of Science, The Ohio State University, 2019, Vision Science

Background: Macular degeneration is a leading cause of blindness in developed nations. Socioeconomic status has been linked to health disparities and poor health outcomes. There is evidence to suggest socioeconomic status can influence macular degeneration outcomes, but it is unclear what links the two. The purpose of this study was to identify potential components of the pathway between socioeconomic status and vision in patients with age-related macular degeneration. Methods: Patients with macular degeneration were recruited from the Ohio State University Department of Ophthalmology retina service. Socioeconomic status was measured in two ways: as a categorical variable of self-reported highest level of education completed and using the Area Deprivation Index associated with the patients' nine-digit zip codes. Visual acuity was measured using back-lit Early Treatment Diabetic Retinopathy Study charts and by-letter scoring with each subject's habitual correction. The influence of uncorrected refractive error was assessed by re-measuring visual acuity using autorefraction values. Prospective survey data were collected, including lifetime pack-years of smoking; dietary intake of nuts, fish, and green vegetables; history of low vision care; and access to transportation. Retrospective chart review was conducted to determine the number of missed clinical appointments. Inflammation was analyzed by measuring levels of C-reactive protein in the blood. Self-reported visual function was assessed using the Impact of Vision Impairment questionnaire. Statistical analysis was conducted using SPSS with better-eye visual acuity as the main outcome measure. Results: Seventy-eight patients (47% female, 82  9 years old) were enrolled. Mean habitual better-eye visual acuity was 59  23 letters. Older participants had poorer habitual visual acuity (r = - 0.515, p<0.001). Subjects with higher levels of education had better visual acuity (p=0.048), but Area Deprivation Index was no (open full item for complete abstract)

Committee: Bradley Dougherty OD, PhD (Advisor); Roanne Flom OD (Committee Member); Dean VanNasdale OD, PhD (Committee Member) Subjects: Ophthalmology; Public Health

Master of Science, The Ohio State University, 2018, Vision Science

Myopia control is currently a topic of interest due to the increasing prevalence of myopia in the pediatric population of the United States and other areas of the world. Those who suffer from highly myopic refractive errors are predisposed to ocular complications due to exaggerated ocular axial elongation. Both orthokeratology and center-distance soft multifocal contact lenses have been proven through randomized clinical trials to be effective at slowing down axial elongation and minimizing myopic refractive error. There is supporting evidence that myopia control can be maximized by increasing the power and the area of the add within the optical design of a soft multifocal contact lens. This study aims to determine the maximum of these multifocal parameters in a center-distance and center-near soft multifocal contact lens design without causing a clinically meaningful reduction in objective and subjective visual performance. In this study, non-presbyopic subjects wore a total of thirteen different contact lenses; a single vision spherical control, six center-distance multifocals, and six center- near multifocals. For each multifocal design, there were two different add powers (+1.50 D and +2.50 D) and three different center optic zone sizes (1.5 mm, 2.0 mm, and 2.5 mm) assessed. Statistically significant differences in distance high-contrast visual acuity was seen as center optic zone size varied for the +1.50 D add center-distance multifocal (p = 0.01). Both distance high-contrast (p = 0.004) and low-contrast (p = < 0.0001) visual acuity showed statically significant differences as center optic zone size varied for the +2.50 D center-distance multifocal. Distance low-contrast (p = 0.001) and near high- contrast (p = 0.01) visual acuities for the 1.5 mm center optic zone center-distance multifocal were statically different as add power varied. Distance vision, computer vision, near vision, glare/starbursts, ghosting, eye-strain, changes/fluctuations, and overal (open full item for complete abstract)

Committee: Jeffrey Walline OD, PhD,FAAO (Advisor); Heidi Wagner OD, MPH, FAAO (Committee Member); Dean VanNasdale OD, PhD, FAAO (Committee Member) Subjects: Optics

Master of Science, The Ohio State University, 2016, Vision Science

Purpose: For an individual not eligible for a regular driver's license due to central visual impairment, 43 states allow for licensure with the aid of bioptic telescope spectacles (BTS). BTS consist of a small telescope lens mounted in the upper portion of a distance prescription lens. There is limited information regarding the driving exposure and road safety of bioptic drivers. The purpose of this study was to determine whether vision or demographic factors predict mileage driven in bioptic drivers and to determine a per mile motor vehicle collisions (MVC) rate. Methods: Data on visual acuity (logMAR charts), contrast sensitivity (Pelli-Robson or Mars charts), age, sex, and previous driving experience were collected retrospectively from clinic records at the Ohio State University College of Optometry. MVC data was collected from the Bureau of Motor Vehicles database. A modified version of the Driving Habits Questionnaire (Owsley et al., 1999) was administered in person or by mail, and subjects were asked to estimate their yearly mileage. Spearman correlation and Mann-Whitney U tests were performed to determine predictors of driving exposure. Per mile MVC rate was calculated and used to compared to calculated MVC rates in the general population. Results: 73 licensed Ohio bioptic drivers (48 male) were included. Mean (±SD) age was 51±16 years. Mean (min, max) binocular logMAR visual acuity was 0.66 (1.20, 0.18), or approximately 20/100. Median contrast sensitivity was 1.57 (1.00, 1.95). Reported annual mileage ranged from 100 to 90,000 miles per year, with a mean of 9,746. Age, gender, and previous (non-bioptic) driving experience were not significantly associated with estimated annual mileage. Visual acuity was inversely related to reported mileage (Spearman correlation = –0.286, P = 0.015). Contrast sensitivity was directly related to reported mileage (Spearman correlation = 0.308, P = 0.009). Glare acuity was inversely related to reported mileage (Spearman (open full item for complete abstract)

Committee: Bradley Dougherty OD, PhD (Advisor); Roanne Flom OD (Committee Member); Dean VanNasdale OD, PhD (Committee Member) Subjects: Ophthalmology; Public Health

Master of Science, The Ohio State University, 2014, Vision Science

A new test of contrast sensitivity (CS), the Stripe Card Contrast Sensitivity (SCCS) test, could serve as a simple and efficient means for estimating the maximum contrast sensitivity value of a given patient without having to use multiple spatial frequency gratings, and without knowing the spatial frequency at which maximum sensitivity occurs. This test could be useful for a wide range of patients with various levels of visual acuity (VA), ages, and diagnoses. We measured VA [Bailey-Lovie (BL), Teller Acuity Cards (TAC)] and CS [Pelli-Robson (PR), SCCS, Berkeley Discs (BD)] in counterbalanced order with subjects at the Ohio State School for the Blind (OSSB). Thus, we tested VA and CS using letter charts (B-L, P-R), grating cards (TAC, SCCS) and a chart with shapes (BD). Vision-related quality of life (QoL) surveys [The Impact of Visual Impairment in Children (IVI_C) and Low Vision Prasad Functional Vision Questionnaire (LVP-FVQ)] were used following vision testing. Additionally, we obtained Michigan Orientation & Mobility (O&M) Severity Rating Scale (OMSRS) severity of need scores for some participants. Testing was performed over a two-year period for 51 participants at OSSB. We have organized our work into three experiments: Experiment I was performed in the 2012-13 school year and included 27 participants who were tested monocularly using the patient's preferred eye. The following year, we returned for repeat testing of 11 participants from the first year (“Experiment IIa”) and additional testing of 24 new participants (“Experiment IIb”). Those assessments were performed on each eye monocularly (where possible) rather than just with the preferred eye. QoL and O&M results were obtained during both years of testing and are detailed in Experiment III. Vision tests on the better eyes correlated positively and significantly with one another, except for a non-significant correlation between the B-L and SCCS. The IVI_C correlated significantly with all vision tests, (open full item for complete abstract)

Committee: Angela Brown PhD (Advisor); Roanne Flom OD (Committee Member); Thomas Raasch OD, PhD (Committee Member) Subjects: Health Care; Ophthalmology

Master of Science, The Ohio State University, 2009, Vision Science

Good near visual acuity is important in for completing near visual tasks at school and at work. There are currently no studies comparing visual acuity procedures in commercially available logMAR near acuity charts. The purpose of this study is to evaluate the near visual acuity scores of the Patti Pics and HOTV charts, two commercially available logMAR charts, against an ETDRS gold-standard chart, as well as the interocular, monocular and binocular visual acuities. Twenty-two subjects aged 6 and above who were able to identify letters and symbols on these charts were invited to participate in the study. Repeated measures analysis of the uncorrected visual acuity scores without adjustments revealed that the subjects' uncorrected visual acuity with the ETDRS chart when compared to the Patti Pics chart was better by -0.042 logMAR units (p =0.017), or about 2 letters. The difference was no longer statistically significant (p=0.052) after Bonferroni adjustment was applied to the data. When compared with HOTV chart, the ETDRS yielded similar results (p=0.111). The results demonstrated a statistically, but not clinically, significant difference in the visual acuity results. When comparing the right eye to the left eye with repeated measures analysis, the right eye results were -0.016 logMAR units or almost one letter better (p= 0.017). When comparing the right eye to both eyes, the visual acuity score for both eyes was better by -0.023 logMAR units, or one letter better (p= 0.007). When comparing the left eye to both eyes, both eyes were better by -0.39 logMAR units, or nearly 2 letters better (p= 0.001). After Bonferroni adjustment, the difference between the right and left eyes approached statistical significance (p=0.05), and the difference between OD and both eyes remained statistically significant (p =0.020), and the difference between OS and both eyes remained statistically significant (p= 0.003). The difference between the inter-ocular, monocular, and binocular visu (open full item for complete abstract)

Committee: Marjean Taylor-Kulp OD, MS (Advisor); Donald Mutti OD, PhD (Committee Member); Michael Earley OD, PhD (Committee Member) Subjects: Optics

Doctor of Philosophy, The Ohio State University, 2009, Vision Science

The reduction in visual resolution due to visual blur is a common experience, especially when individuals requiring eyewear remove their spectacles or contact lenses. However,studies have shown that when one looks continually at a visual acuity chart through blur, the smallest letters that one can read at first are not as small as the letters that one can read several minutes later. This improvement in sensitivity following a period of exposure to blur is referred to as blur adaptation. The purpose of this dissertation is to evaluate the temporal and spatial aspects of blur adaptation. Ten subjects were enrolled in each of the three visual acuity studies. The temporal characteristics were assessed, firstly, by varying the initial blur exposure duration (0min, 1min, 5min and 15min exposures) to a natural scene image. Visual acuity measured using a short 1.5min and a long 10min computer-based letter presentations, using Bailey-Lovie optotypes, was the outcome measure. Secondly, the influence of varying letter exposure durations was tested using three letter presentation times (2sec, 4sec and 15sec exposure per letter). The spatial characteristics of adaptation were assessed by adapting to a blurred natural scene, visual acuity chart, and different sets of alphabets presented in large and small sizes. A fourth study, carried out on one subject, looked at the effects of blur adaptation on the contrast sensitivity function. It was seen that visual acuity was not influenced by the four initial blur exposure durations to the natural scene. Also, adaptation to stimuli with various spatial characteristics like a natural scene, acuity chart, and letters of varying sizes did not result in different acuity scores. However, there was a significant influence of test letter presentation duration. Acuity was better with long acuity presentation times compared to short presentation times. The acuity score from the 15sec per letter presentation was better than those from 2sec per let (open full item for complete abstract)

Committee: Donald Mutti OD, PhD (Advisor); Delwin Lindsey PhD (Committee Member); Thomas Raasch OD, PhD (Committee Member); Mathew Allen VetMB, PhD (Committee Member) Subjects: Optics

Doctor of Philosophy, The Ohio State University, 2004, Physiological Optics

We examined existing data from Food and Drug Administration (FDA) clinical trials for approved ophthalmic lasers to determine if trends for improvement in outcomes occurred with changes in laser technology. The repeatability of autorefraction measurements, visual acuity measurements, and the National Eye Institute Refractive Error Quality of Life (NEI-RQL-42) Questionnaire was evaluated in laser in situ keratomileusis (LASIK) patients. We also compared the performance of the NEI-RQL-42 to another survey for refractive surgery patients to see if similar results were obtained when subjects completed the surveys simultaneously. Finally, we evaluated patient survey responses and opinions of eye care practitioners to provide direction for generating hypotheses for future research studies. We found that cycloplegic autorefraction measurements with the Grand Seiko autorefractor were repeatable and agreed well with subjective refraction. The NEI-RQL-42 was determined to have an acceptable level of repeatability and produced results that were similar to other studies that tested refractive surgery patients. Measurements of low-contrast visual acuity under various lighting conditions were also found to have acceptable levels of repeatability, and 5% contrast visual acuity appears to be sensitive to differences between LASIK and non-LASIK patients. When evaluating reasons why patients would recommend LASIK to others, we determined that the primary reason was to eliminate the need for glasses and/or contact lenses. Focus group sessions with eye care practitioners revealed that practitioners would like to have more information about the relationship between patient personality and psychological issues and satisfaction with the results of the procedure. The eye care practitioners defined a successful LASIK procedure as one in which the patients had good uncorrected visual acuity, refractive error within ± 0.50 D of the intended correction, and no new or increase in night vision o (open full item for complete abstract)

Committee: Karla Zadnik (Advisor) Subjects: Health Sciences, General