Schiefer et al. provided a comprehensive and instructive overview of the most important refractive errors, highlighting typical functional impairments of relevance to physicians not specialized in ophthalmology (1).
I would like to contribute the following additions:
In her handbook article (p. 972), Aulhorn (2) already reported that the shortsighted often experience poor vision at night, especially while driving. In her opinion, some ophthalmologists do not completely correct myopia in some cases. Due to high luminance, pupils are small during the day. In this situation, slightly under-corrected glasses are generally well tolerated, but at night, when the pupils are wider, any loss in visual acuity may be experienced as troublesome. In addition, a true night myopia of about 1.0 to 1.5 dpt may occur in some people. These patients require glasses for night driving.
Schiefer et al. introduced the internationally renowned and diagnostically important Amsler test for the detection of metamorphopsia. In addition to the Amsler grid, Weiss (3) pointed out the diagnostic importance of a so far little known test which involves the assessment of lines running in a spoke-like fashion to a center point. Binder et al. (4) highlighted the existence of “labile“ metamorphopsia detectable with this spoke test.
Schiefer et al. introduced the computerized visual acuity testing which plays an important role in clinical practice and is available online. For the sake of completeness, I would like to add here that Crossman et al. and Timberlake et al. already emphasized the importance of the computerized acuity testing in 1970 and 1980, respectively.
Prof. Dr. med. Dieter Schmidt
Klinik für Augenheilkunde der Universität Freiburg, Germany
Conflict of interest statement
The author declares that no conflict of interest exists.
|1.||Schiefer U, Kraus C, Baumbach P, Ungewiß J, Michels R: Refractive errors—epidemiology, effects and treatment options. Dtsch Arztebl Int 2016; 113: 693–702 VOLLTEXT|
|2.||Aulhorn E: Funktionsprüfung des Auges zur Feststellung der Kraftfahreignung. In: Straub W (ed.): Die ophthalmologischen Untersuchungsmethoden, Band II. Stuttgart: F. Enke Verlag 1976; 922–90.|
|3.||Weiss H: Untersuchungen zur Bestimmung und Bewertung von Metamorphopsien. Graefes Arch Klin Exp Ophthalmol 1971; 183: 105–36 CrossRef|
|4.||Binder S, Kutschera E, Weiß H: Die Makulafunktion nach postoperativer Wiederanlegung der Netzhaut. Klin Monatsbl Augenheilkd 1977; 171: 606–10 MEDLINE|