Double vision Health Dictionary

A scienti?c study in which di?erent patients receive a di?erent drug, the same drug at a different dose, or a placebo – with neither the investigators assessing the outcome nor the subjects being treated knowing which of these the latter are receiving. The aim is to remove any hint of bias due to the investigators’ or patients’ preferences or preconceptions. The results are analysed after all the data have been collected and the code has been broken. Trials should have a separate supervising committee, the members of which know the code but do not take part in the study. Their job is to check the results at intervals so they can stop the trial if one arm of treatment is clearly better than another. Otherwise, it would be unethical to continue. (See INTERVENTION STUDY.)... double blind trial

Broadly speaking, vision is the ability to see.

Pathway of light from the eye to the brain Light enters the EYE by passing through the transparent cornea, then through the aqueous humour ?lling the anterior chamber. It then passes through the pupil, through the lens and the vitreous to reach the retina. In the retina, the rod and cone photoreceptors detect light and relay messages in the form of electrochemical impulses through the various layers of the retina to the nerve ?bres. The nerve ?bres carry messages via the optic nerve, optic chiasma, optic tract, lateral geniculate body and ?nally the optic radiations to the visual cortex.

Here in the visual cortex these messages are interpreted. It is therefore the visual cortex of the BRAIN that ‘sees’.

Visual acuity Two points will not be seen as two unless they are separated by a minimum distance. This distance is such that the objects are so far apart that the lines joining them to the eye enclose between them (subtend) an angle of at least one minute of a degree. This amount of separation allows the images of the two points to fall on two separate cones (if the light from two points falls on one cone, the two points would be seen as a single point). There are many tests of visual acuity. One of the more common is the Snellen test type. This is made up of many letters of di?erent size. By conventions the chart is placed 6 metres away from the patient. Someone able to see the lowest line at this distance has a visual acuity of 6/4. If they are only able to see the top letter they have 6/60 vision. ‘Normal’ vision is 6/6.

Colour vision ‘White light’ is made up of component colours. These can be separated by a prism, thereby producing a spectrum. The three cardinal colours are red, green, and blue; all other colours can be produced by a varying mixture of these three. Colour vision is a complex subject. The trichromat theory of colour vision suggests that there are three types of cones, each type sensitive to one of the cardinal colours. Colour perception is based on di?erential stimulation of these cone types. The opponent colour theory suggests that each cone type can generate signals of the opposite kind. Output from some cones can collaborate with the output from others or can inhibit the action of other cones. Colour perception results from these various complex interactions.

Defective colour vision may be hereditary or acquired, and can occur in the presence of normal visual acuity. HEREDITARY DEFECTIVE COLOUR VISION is more common in men (7 per cent of males) than women (0·5 per cent of females). Men are affected, but women convey the abnormal gene (see GENES) to their children. It occurs because one or more of the photopigments of the retina are abnormal, or the cones are damaged. Red-green colour defect is the most common. ACQUIRED DEFECTIVE COLOUR VISION is the result of disease of the cones or their connections in the retina, optic nerve or brain – for example, macular disease, optic neuritis. Col-our vision can be impaired but not lost as a result of corneal opaci?cation or cataract formation (see under EYE, DISORDERS OF).

TESTS OF COLOUR VISION These use specially designed numbers made of coloured dots surrounded by dots of confusing colour (e.g. plates).... vision

Most vision tests examine a person’s sharpness of VISION (visual acuity) and often of the ?eld of vision (see VISION, FIELD OF). Refraction tests assess whether a person has an error that can be corrected with glasses such as ASTIGMATISM, HYPERMETROPIA or MYOPIA. Visual acuity is tested using a Snellen chart when the patient tries to read letters of di?ering standard sizes from 6 metres away. The optician will prescribe lenses to correct any defects detected by vision tests.... vision tests

The list of disorders resulting in poor or dim vision is huge. Disturbance of vision can result from an uncorrected refractive error, disease or injury of the cornea, iris, lens, vitreous, retina, choroid or sclera of the EYE. It may also result from disease or injury to the structures comprising the visual pathway from the retina to the occipital cortex (see VISION – Pathway of light from the eye to the brain) and from lesions of the structures around the eye – for example, swollen lids, drooping eyelids. (See EYE, DISORDERS OF.)... vision, disorders of

Refer: ALCOHOLISM, CATARACT, CONJUNCTIVITIS, DIABETES, ECLAMPSIA, GLAUCOMA, IRITIS, MIGRAINE, MULTIPLE SCLEROSIS, RETINITIS, SHOCK. ... blurred vision

Loss of the peripheral visual field to the extent that only objects straight ahead can be seen clearly. Tunnel vision is most commonly caused by chronic glaucoma. Retinitis pigmentosa is another possible cause.... tunnel vision

A type of controlled trial that tests the effectiveness of a treatment or compares the benefits of different treatments.

In double-blind trials, neither the patients nor the doctors assessing the treatments know which patients are receiving which treatment.

This eliminates any expectations about which treatment will be most effective.... double-blind

the ability to focus both eyes on an object at the same time, so that a person sees one image of the object he is looking at. It is not inborn, but acquired during the first few months of life. Binocular vision enables judgment of distance and perception of depth. See also stereoscopic vision.... binocular vision

a technique usually used in X-ray examinations of the bowel. Barium sulphate *contrast medium (first contrast) is used to coat the bowel wall. The bowel is then distended with gas (second contrast). The X-ray images obtained give exquisite detail of the lining of the gut. See also barium enema; barium swallow and meal.... double contrast

When the eye looks at a speci?c point or object, that point is seen clearly. Other objects within a large area away from this ?xation point can also be seen, but less clearly. The area that can be seen around the ?xation point, without moving the eye, is known as the ?eld of vision. The extent of the ?eld is limited inwards by the nose, above by the brow and below by the cheek. The visual ?eld thus has its greatest extent outwards from the side of the head. The ?eld of vision of each eye overlaps to a large extent so that objects in the centre and towards the inner part of each ?eld are viewed by both eyes together. Because the eyes are set slightly apart, each eye sees objects in this overlapping part of the ?eld slightly di?erently. It is because of this slight di?erence that objects can be perceived as three-dimensional.

Defects in the visual ?eld (scotomas) can be produced by a variety of disorders. Certain of these produce speci?c ?eld defects. For example, GLAUCOMA, some types of brain damage and some TOXINS can produce speci?c defects in the visual ?eld. This type of ?eld defect may be very useful in diagnosing a particular disorder. The blind spot is that part of the visual ?eld corresponding to the optic disc. There are no rods nor cones on the optic disc and therefore no light perception from this area. The blind spot can be found temporal (i.e. on the outer side) of the ?xation point. (See also EYE.)... vision, field of

The ability to see different parts of the colour spectrum. Light perceived by the human eye consists of electromagnetic radiation (energy waves) with a spectrum of different wavelengths

between about 400 and 700 nanometres. Different wavelengths produce sensations of violet, indigo, blue, green, yellow, orange, and red when they fall on the retina and stimulate nerve signals, which are processed in the brain.

As light falls on the retina, it strikes light-sensitive cells called rods and cones. The rods can detect all visible light, but only the cones can distinguish colour. There are 3 types of cones: red-sensitive, blue-sensitive, and green-sensitive. Each responds more strongly to a particular part of the light spectrum. Because the cones are most concentrated in a central area of the retina called the fovea, colour vision is most accurate for objects viewed directly and is poor at the edges of vision. When light hits a cone, it causes the cone to emit an electrical signal, which passes to the brain via the optic nerve. Colour perception requires a minimum level of light, below which everything is seen as shades of grey. (See also colour vision deficiency; eye; perception; vision.)... colour vision

Any abnormality in colour vision that causes difficulty distinguishing between certain colours. Total absence of colour vision (monochromatism) is rare. The most common types of colour vision deficiency are reduced discrimination of red and green. Most cases of red and green colour vision deficiency are caused by defects in the light-sensitive cells in the retina. These defects are usually inherited, although occasionally defects are caused by retinal or optic nerve diseases or injury. The inherited defects tend to be sex-linked (see genetic disorders), which means that the majority of sufferers are male. A person with a severe green deficiency has difficulty distinguishing oranges, greens, browns, and pale reds. In severe red deficiency, all reds appear dull. A much rarer deficiency in which blue cannot be distinguished may be inherited or may be due to degeneration of the retina or optic nerve.... colour vision deficiency

Inability to see. This may develop slowly or suddenly and may be temporary or permanent, depending on the cause. Vision loss may affect 1 or both eyes. It can cause complete blindness or may affect only peripheral, or only central, vision.

Progressive loss of visual clarity is common with advancing age and may be due to a number of disorders (see vision, disorders of).

Sudden loss of vision may be caused by disorders such as hyphaema, severe uveitis, vitreous haemorrhage, or retinal haemorrhage.

Optic neuritis can reduce vision in 1 eye.

Damage to the nerve connections between the eyes and brain, or to the visual area of the brain, can cause loss of peripheral vision and may be a result of embolism, ischaemia, tumour, inflammation, or injury.... vision, loss of

the situation in which a patient (the inducer) presents with delusional symptoms that he or she believes to be shared by someone else who is incapable of expressing them (typically a child or a pet). This is different from a *delusion by proxy, in which the inducer does not claim to be experiencing the symptoms himself or herself. The term was introduced in 2015 by Peter Lepping, Mark Rishniw, and Roland Wolfgang Freudenmann. Compare folie à deux.... double delusion

see stent.... double j stents

(DORV) a congenital defect of the heart in which both the aorta and the pulmonary artery arise predominantly from the right ventricle anterior to the ventricular septum with an associated *ventricular septal defect (VSD). The relationship between the site of the VSD and the great arteries must be taken into account for surgical repair. DORV can be associated with chromosomal defects.... double-outlet right ventricle

see uterus didelphys.... double uterus

see visual field.... field of vision

(stereopsis) perception of the shape, depth, and distance of an object as a result of having *binocular vision. The brain receives two distinct images from the eyes, which it interprets as a single three-dimensional image.... stereoscopic vision

the principle that, where it is foreseen that a single action will have both a good and a bad outcome, a person may perform such an action provided that (a) he or she intends only the positive outcome, (b) the bad outcome is not disproportionate to the good, and (c) the good outcome is not a direct consequence of the bad. The classic example occurs where a terminally ill patient requires high doses of opiates for pain relief that may also depress respiratory function and hasten his or her death. In such a case the law holds that the doctor may supply the necessary dosage without this being considered tantamount to *euthanasia, even though the outcome will be the same, i.e. the morality of the action does not lie in its consequences (see consequentialism).... doctrine of double effect