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Journal articles on the topic 'Encircling scleral buckle'

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1

Skondra, Dimitra, Corey Westerfeld, and Demetrios G. Vavvas. "Modified Controlled Encircling Scleral Buckle for Retinal Detachment." Journal of VitreoRetinal Diseases 1, no. 5 (2017): 314–16. http://dx.doi.org/10.1177/2474126417725218.

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During encircling scleral buckle placement, the ends of the element are tightened to achieve a shortened radius of the eye. The determining factor of the final buckle height is subjective using usually a combination of the buckle height visualized with the degree of scleral indentation and can be difficult to be taught early on to trainees. Here, we describe a case series in which a modified controlled encircling scleral buckle technique that simplifies and standardizes the achievement of reproducible buckle height of about a 1 mm is objective and easy to be taught. This novel encircling scler
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2

Alves da Costa Pertuiset, Paulo A., Rodrigo A. Fanjul Dominguez, and Pedro R. Gianello Garrido. "Modified Hamilton’s Controlled Encircling Procedure for Retinal Detachment." Journal of VitreoRetinal Diseases 1, no. 5 (2017): 317–20. http://dx.doi.org/10.1177/2474126417725230.

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Purpose: To describe a novel, simple, and reproducible encircling scleral buckle technique based on Hamilton’s controlled encircling procedure in order to standardize buckle height achievement in cases of retinal detachment. Methods: We describe a case series in which a novel modification of Hamilton’s surgical technique was used, consisting of a typical encircling buckling procedure anchored in the center of each quadrant, with the ends of the band passed through a Watzke sleeve. Reference marks were placed to allow measurable shortening of the band when its ends were pulled to create an enci
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Motose, Yasuyoshi, Hiroto Terasaki, Misaki Ichiki, et al. "Simultaneous Occurrence of Buckle Infection and Migration: A Case Report." Medicina 59, no. 3 (2023): 449. http://dx.doi.org/10.3390/medicina59030449.

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Background: When scleral buckling is performed using a #240 encircling band anterior to the equator for rhegmatogenous retinal detachment, buckle migration may occur anteriorly, eroding the rectus muscle. There are few cases of buckle migration occurring simultaneously with buckle infection. Notably, most previous reports included inadequate data on the pathophysiology of buckle migration and did not include the Hess test and perioperative images. Case presentation: A 36-year-old man with a history of atopic dermatitis underwent scleral buckling for rhegmatogenous retinal detachment of the lef
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4

Gras, Hernán E., María Gómez-Resa, Fernando Aguirre, and Borja Corcóstegui. "A new instrument to simplify encircling buckle placement." European Journal of Ophthalmology 29, no. 4 (2018): 464–67. http://dx.doi.org/10.1177/1120672118777102.

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Purpose: The purpose of this study is to describe a new surgical instrument that simplifies 360° silicone band placement, alone or in combination with pars plana vitrectomy, for the treatment of rhegmatogenous retinal detachment. Methods: The instrument has a straight shank and a curved component in the form of a partial helix, whose purpose is to encircle the perimeter of the eye globe below the rectus muscles. The distal tip of the helix is inserted through a small conjunctival incision in the superior temporal quadrant, and the shank is rotated 360° on its axis until the tip emerges from th
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5

Galbinur, Tural, and Itay Chowers. "Scleral Buckle Extrusion Associated with Phthisis." Case Reports in Ophthalmological Medicine 2011 (2011): 1–2. http://dx.doi.org/10.1155/2011/942946.

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Exposure of implanted episcleral element is a rare complication of buckling procedures. We describe a 40-year-old man who presented to our clinic complaining of foreign body sensation and irritation in his left eye which lasted several months. The patient history was positive for bilateral rhegmatogenous retinal detachment which was treated with sclera buckling. Upon presentation the left eye demonstrated phthisis and an exposed and infected sclera buckle and explant in the lower quadrants. The explant was removed, and the patient was treated with antibiotics. This case suggests that wide enci
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6

Vu, Daniel M., and Anna K. Junk. "XEN Gel Stent Implantation Following Encircling Scleral Buckle Surgery." Ophthalmic Surgery, Lasers and Imaging Retina 51, no. 5 (2020): 289–92. http://dx.doi.org/10.3928/23258160-20200501-07.

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7

Pinninti, Usha R., Alice R. McPherson, and Petros E. Carvounis. "LONG-TERM RISK OF GLAUCOMA AFTER ENCIRCLING SCLERAL BUCKLE." Retina 35, no. 6 (2015): 1084–86. http://dx.doi.org/10.1097/iae.0000000000000444.

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8

Kazaikin, V. N., A. Yu Kleymenov, A. V. Lizunov, E. M. Murashova, M. A. Lipina, and G. V. Chashchin. "A software for individual calculation of encircling buckle (circular band) length." Russian Ophthalmological Journal 16, no. 4 (2023): 24–29. http://dx.doi.org/10.21516/2072-0076-2023-16-4-24-29.

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Large-scale introduction of automated processes into medical practice, including ophthalmology, can simplify the diagnosis and treatment of patients. Being part of the general biological system of the body, the eye is an exemplary object of mathematical modeling targeted at treatment optimization, — e. g. when choosing a surgical tool for retinal detachment surgery.Purpose: to develop a software for automatic calculation of the individual length of the circular band to be used in retinal detachment treatment in order to achieve the optimal height of scleral indentation.Materials and methods. T
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9

Lee, Kyeong Joo, Hae Jung Sun, Kyung Seek Choi, Sung Jin Lee, and Hyuna Kim. "Ocular Movement Disorder after Scleral Buckling Surgery in Patients with Retinal Detachment." Journal of the Korean Ophthalmological Society 64, no. 12 (2023): 1238–44. http://dx.doi.org/10.3341/jkos.2023.64.12.1238.

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Purpose: Binocular diplopia is a primary complication that may arise after scleral buckling surgery in patients with rhegmatogenous retinal detachment. This study examined the incidence of and risk factors for binocular diplopia after scleral buckling surgery; it also evaluated the rate of strabismus surgery success in patients with diplopia.Methods: Medical records of 417 patients who underwent scleral buckling surgery for rhegmatogenous retinal detachment at a single institution from January 2017 to June 2022 were retrospectively reviewed. Patients who experienced binocular diplopia for >
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10

Özdek, Şengül, Murat Hasanreisoğlu, Ufuk Adıgüzel, and Zeynep Aktaş. "Secondary Glaucoma Associated with Encircling Scleral Buckle Migration into the Cornea." Türk Oftalmoloji Dergisi 46, no. 1 (2016): 44–46. http://dx.doi.org/10.4274/tjo.02679.

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11

Mafi, Mostafa, Masoud Mirghorbani, Hossein Ghahvehchian, et al. "Modified Encircling Scleral Buckle Technique Without Subretinal Fluid Drainage or Retinopexy." Ophthalmology and Therapy 9, no. 3 (2020): 641–51. http://dx.doi.org/10.1007/s40123-020-00279-1.

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12

Taleb, Eman Abo, Manish p. Nagpal, Navneet S. Mehrotra, and Raddhi Arya. "Outcome and SD-OCT Macular Findings Following Surgery in Spared Macula Giant Retinal Tear Retinal Detachment." Journal of Ophthalmic Science 2, no. 2 (2019): 17–22. http://dx.doi.org/10.14302/issn.2470-0436.jos-19-2829.

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Purpose To study outcome and spectral domain optical coherence tomography (SD-OCT) macular findings in patients who underwent surgery for spared macula giant retinal tear (GRT) retinal detachment. Methods a retrospective study of 12 patients with spared macula giant retinal tear (GRT) retinal detachment who underwent vitrectomy (N=7), vitrectomy with an encircling scleral buckle (n=4) and scleral buckle (n=1) with at least 3 months follow up after silicon oil removal (SOR) . Post-SOR macular SD-OCT scans were studied in all eyes. Results Final reattachment achieved in all eyes with single prim
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13

Francesco, Barca MD*, Pacini MD Bianca, Caporossi PhD Tomaso, De Angelis MD Lorenzo, Oliverio MD Leandro, and Rizzo MD Stanislao. "Risk of Retinal Detachment Recurrence after Macular Surgery in eyes previously treated with 360° Encircling Band." Journal of Ophthalmology and Vision Research 3, no. 2 (2021): 1–6. https://doi.org/10.5281/zenodo.5494450.

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<strong>Abstract</strong> <strong>Aims:</strong> To evaluate functional outcomes and the safety profile of Pars Plana Vitrectomy (PPV) procedure for macular diseases in eyes already subjected to successful Scleral Buckle (SB) operation with encircling 360&deg; band for Retinal Detachment (RD). <strong>Methods:</strong> Observational, retrospective, consecutive case series on 55 patients affected by epiretinal membrane or macular hole, and previously subjected to encircling SB surgery for RD. All the patients underwent PPV procedure from May 2017 to September 2019 and they were followed up for
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14

Yannuzzi, Nicolas A., Nimesh A. Patel, Audina M. Berrocal, and Jayanth Sridhar. "Encircling Scleral Buckle with Chandelier Endoillumination and Endolaser for Repair of Rhegmatogenous Retinal Detachment." Clinical Ophthalmology Volume 14 (February 2020): 609–12. http://dx.doi.org/10.2147/opth.s238241.

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15

Al-Khairi, A. M., E. Al-Kahtani, D. Kangave, and A. M. Abu El-Asrar. "Prognostic Factors Associated with Outcomes after Giant Retinal Tear Management Using Perfluorocarbon Liquids." European Journal of Ophthalmology 18, no. 2 (2008): 270–77. http://dx.doi.org/10.1177/112067210801800216.

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Purpose To identify prognostic factors for visual acuity and anatomic outcomes associated with giant retinal tear management using intraoperative perfluorocarbon liquids. Methods All patients with giant retinal tears without proliferative vitreoretinopathy (PVR) who underwent management with intraoperative perfluorocarbon liquids between 1994 and 2005 were re-viewed. Results The study included 115 patients (117 eyes), 93 (80.9%) males and 22 (19.1%) females, with a mean age of 30.3±15.2 years. Mean follow-up period was 29.7±26.7 months. Success rate with primary procedure was 78.6%, which incr
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16

Schmidt, I., N. Plange, G. Rößler, et al. "Long-term Clinical Results of Vitrectomy and Scleral Buckling in Treatment of Rhegmatogenous Retinal Detachment." Scientific World Journal 2019 (March 6, 2019): 1–7. http://dx.doi.org/10.1155/2019/5416806.

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Purpose. Most studies about retinal detachment cover a limited follow-up period. The purpose of this research is to assess the long-term results after pars plana vitrectomy (PPV) and scleral buckle (SB) surgery in patients with rhegmatogenous retinal detachment (RRD). Methods. 155 patients with RRD are treated either with SB or PPV with a mean follow-up of more than 5 years. Retrospective analysis of patient data with RRD was performed between January 2006 and June 2008 at a tertiary eye clinic. Results. Overall primary success rate was 85.2% (PPV: 84.6%, SB: 89.5%; p=0.57). 90.5% of redetachm
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17

Abdel Hafez, Mahmoud A. M., Nahla Borhan, Mohamed Attya, and Mohamed A. Zayed. "Combined vitrectomy and scleral buckle versus vitrectomy with heavy silicone oil tamponade in the management of primary rhegmatogenous retinal detachment with inferior proliferative vitreoretinopathy." Journal of the Egyptian Ophthalmological Society 116, no. 3 (2023): 175–80. http://dx.doi.org/10.4103/ejos.ejos_1_23.

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Purpose The aim was to compare the anatomical and functional success between combined scleral buckling with pars plana vitrectomy (PPV) and PPV with heavy silicone oil (HSO) tamponade in treating inferior proliferative vitreoretinopathy (PVR) grade C in primary rhegmatogenous retinal detachment. Patients and methods A nonrandomized comparative study was performed on 33 eyes of 33 patients presenting with inferior PVR grade C complicating primary rhegmatogenous retinal detachment. Sixteen eyes underwent PPV with the HSO tamponade namely Densiron 68 that were classified as the heavy-oil group; 1
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18

DʼHERMIES, FRANÇOIS, JEAN-FRANCOIS KOROBELNIK, ANNE MEYER, DOMINIQUE CHAUVAUD, YVES POULIQUEN, and GILLES RENARD. "EXPERIMENTAL ENCIRCLING SCLERAL BUCKLE WITH SILICONE AND HYDROGEL: Histopathologic and Comparative Study of 26 Rabbit Eyes." Retina 19, no. 2 (1999): 148–57. http://dx.doi.org/10.1097/00006982-199902000-00011.

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19

Wilde, Craig, Mary Awad, Gavin Orr, Dharmalingam Kumudhan, Saker Saker, and Anwar Zaman. "Incidence of Clinically Significant Aniseikonia Following Encircling Scleral Buckle Surgery: An Evaluation of Refractive and Axial Length Changes Requiring Intervention." Vision 5, no. 1 (2021): 7. http://dx.doi.org/10.3390/vision5010007.

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To evaluate the incidence of symptomatic anisometropia and aniseikonia requiring intervention following surgery with combined pars plana vitrectomy (PPV) and broad 276 style encircling scleral buckle (ESB) for the repair of rhegmatogenous retinal detachments (RRD) and to report axial length (AL) and keratometry changes, a retrospective review of consecutive RRD patients treated with combined PPV and ESB between June 2016 until September 2019 was performed. All patients with symptomatic optically induced aniseikonia requiring additional interventions or surgical procedures including clear lens
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20

Falkner-Radler, Christiane I., Alexandra Graf, and Susanne Binder. "Vitrectomy combined with endolaser or an encircling scleral buckle in primary retinal detachment surgery: a pilot study." Acta Ophthalmologica 93, no. 5 (2015): 464–69. http://dx.doi.org/10.1111/aos.12663.

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21

Kim, Sung Soo, and William E. Smiddy. "SURGICAL TECHNIQUE FOR THE PLACEMENT OF AN ENCIRCLING SCLERAL BUCKLE IN THE PRESENCE OF A GLAUCOMA DRAINAGE DEVICE." Retinal Cases & Brief Reports 5, no. 4 (2011): 369–71. http://dx.doi.org/10.1097/icb.0b013e3182240904.

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22

GOEZINNE, FLEUR, ELLEN C. LA HEIJ, TOS T. J. M. BERENDSCHOT, et al. "LOW REDETACHMENT RATE DUE TO ENCIRCLING SCLERAL BUCKLE IN GIANT RETINAL TEARS TREATED WITH VITRECTOMY AND SILICONE OIL." Retina 28, no. 3 (2008): 485–92. http://dx.doi.org/10.1097/iae.0b013e318150d879.

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23

Vukovic, Dragan, Sanja Petrovic-Pajic, and Predrag Paovic. "Retinal detachment in the eye with the choroidal coloboma." Srpski arhiv za celokupno lekarstvo 142, no. 11-12 (2014): 717–20. http://dx.doi.org/10.2298/sarh1412717v.

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Introduction. Choroidal coloboma is a congenital defect caused by an inadequate closure of embryonic fissure. About 40% of the eyes with the choroidal coloboma (CHC) develop the retinal detachment (RD). It is extremely difficult to manage these cases due to the lack of pigmentation at the site of choroidal coloboma. Outline of Cases. This is a case series of five patients with CHC and RD who were successfully operated using one of two different surgical techniques: pars plana vitrectomy (PPV) + silicone oil internal tamponade and/or scleral buckle with encircling band with laser photocoagulati
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HARRIS, MICHAEL J., MARK S. BLUMENKRANZ, JOHN WITTPENN, ANDREW LEVADA, REAY BROWN, and SANDRA FRAZIER-BYRNE. "GEOMETRIC ALTERATIONS PRODUCED BY ENCIRCLING SCLERAL BUCKLES." Retina 7, no. 1 (1987): 14–19. http://dx.doi.org/10.1097/00006982-198700710-00003.

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HARRIS, MICHAEL J., MARK S. BLUMENKRANZ, JOHN WITTPENN, ANDREW LEVADA, REAY BROWN, and SANDRA FRAZIER-BYRNE. "GEOMETRIC ALTERATIONS PRODUCED BY ENCIRCLING SCLERAL BUCKLES." Retina 7, no. 1 (1987): 14–19. http://dx.doi.org/10.1097/00006982-198707010-00003.

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26

Gomaa, Amir Ramadan, and Samir Mohamed Elbaha. "Applying Sutureless Encircling Number 41 Band and Transscleral Chandelier-Assisted Laser Retinopexy for Scleral Buckling Procedure." Journal of Ophthalmology 2017 (2017): 1–6. http://dx.doi.org/10.1155/2017/4671305.

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Purpose. To assess the outcome of sutureless encirlcing number 41 band and transscleral laser retinopexy in uncomplicated rhegmatogenous retinal detachment (RRD), using a wide-angle viewing system (WAVS) and chandelier endoillumination.Methods. Prospective intervention study included 30 eyes of 30 patients presenting with RRD of recent onset indicated for SB. All cases were treated by sutureless encircling number 41 band and transscleral laser retinopexy. Visualization was provided by the Resight WAVS and a single 27-gauge chandelier endoillumination. Anatomical and visual outcomes were evalua
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Sonntag, Svenja Rebecca, Olaf Wittenstein, Oliver Blanck, et al. "Silicone Fiducial Markers Improve Precision in Uveal Melanoma Radiation Therapy." Cancers 17, no. 2 (2025): 189. https://doi.org/10.3390/cancers17020189.

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Objectives: Accurate target definition, treatment planning and delivery increases local tumor control for radiotherapy by minimizing collateral damage. To achieve this goal for uveal melanoma (UM), tantalum fiducial markers (TFMs) were previously introduced in proton and photon beam radiotherapy. However, TFMs cause pronounced scattering effects in imaging that make the delineation of small tumors difficult. The aim of this study was to evaluate silicone fiducial markers (SFMs) for the guiding of stereotactic radiosurgery (SRS) for UM. Methods: In this retrospective interventional pilot case s
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28

Budoff, Greg, Alexander B. Dillon, Adrian Au, Allan E. Krieger, and Steven D. Schwartz. "Unexplained Acute Total Loss of Vision After Primary Scleral Buckle Surgery." Journal of VitreoRetinal Diseases, June 22, 2024. http://dx.doi.org/10.1177/24741264241260483.

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Purpose: To present 2 cases of acute total loss of vision after scleral buckle surgery for rhegmatogenous retinal detachment. Methods: A retrospective chart review of 2 cases and an analysis of the literature were performed. Results: An 18-year-old woman and a 67-year-old woman suffered complete loss of vision in their operative eye after primary scleral buckle surgery with encircling bands. Conclusions: Profound ocular ischemia resulting in total acute vision loss is a rare and devastating outcome of primary scleral buckle procedures and may be caused by strangulation of the eye with an encir
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29

Ricci, Benedetto, and Francesco Ricci. "Octyl 2‐cyanoacrylate tissue adhesive in experimental scleral buckling." March 11, 2003. https://doi.org/10.1034/j.1600-0420.2001.790516.x.

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ABSTRACT.Purpose: In this experimental study, a sutureless scleral buckling was performed by using a tissue adhesive glue to fixate a silicone band to the sclera. In fact, one of the major risks of traditional scleral buckling is accidental perforation of the bulb, which is more frequent when the sclera is extremely thin as it is in newborns or in eyes with high myopia or scleromalacia.Methods: An encircling band of silicone, which is generally anchored to the sclera itself, was sutured in 36 rabbit eyes to three small silastic patches that had been glued to the sclera, at the level of the equ
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30

Enghelberg, Moises, and K. V. Chalam. "Ultra wide field angiography documented peripheral retinal eovascularization as cause of vitreous hemorrhage after scleral buckle surgery#." Journal of Surgical Case Reports 2020, no. 6 (2020). http://dx.doi.org/10.1093/jscr/rjaa142.

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Abstract We describe an unusual case of ultra wide fluorescein angiography (UWFA) documented peripheral retinal neovascularization (NVE) with delayed vitreous hemorrhage after placement of an encircling scleral buckle (a common procedure for repair of retinal detachment). Anterior segment ischemia is a rare complication after scleral buckle surgery for the treatment of retinal detachment and results from altered choroidal flow through the impingement of the anterior and long posterior ciliary arteries. UWFA performed for the evaluation of vitreous hemorrhage confirmed ischemia anterior to the
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Desai, Arjun, Mudit Tyagi, and Ritesh Narula. "Frosted Branch Angiitis–Like Retinal Vasculitis Developing After Scleral Buckle Surgery." Journal of VitreoRetinal Diseases, December 20, 2024. https://doi.org/10.1177/24741264241304810.

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Purpose: To describe a case of frosted branch angiitis–like retinal vasculitis that developed after scleral buckle surgery. Methods: A single case was evaluated. Results: Five days after nondrainage scleral buckle surgery with a segmental buckle and encircling band, an otherwise healthy 39-year-old man presented with frosted branch angiitis. Treatment initially involved oral corticosteroids. After 5 days of treatment, there was a decrease in the subretinal exudation; however, the break appeared to be lifting with persistent subretinal fluid. Pars plana vitrectomy (PPV) with silicone oil (SO) i
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32

Simanjuntak, Gilbert W. S., Biju Raju, Golda A. M. Simanjuntak, and Reinne Natali. "Outcome of Primary Management of Scleral Rupture without Vitrectomy Jakarta Eye Trauma Study." Open Ophthalmology Journal 16, no. 1 (2022). http://dx.doi.org/10.2174/18743641-v16-e2207220.

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Introduction: To report the outcome of primary management of scleral rupture without vitrectomy. Methods: Descriptive retrospective study of primary surgical management of scleral rupture located anterior to the equator. Initial and final visual acuity (FVA, intra ocular pressure, type of injury (sharp/blunt/projectile), wound length, time interval between the incident and primary repair and cause of injury were recorded. Encircling scleral buckle was placed in case of scleral laceration reaching muscle insertion. Patients who had a follow up of 3 months after the primary repair were included
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Kortuem, Friederike C., Focke Ziemssen, Jonas Neubauer, Karl Ulrich Bartz-Schmidt, and Spyridon Dimopoulos. "Introducing a customized low-cost macular buckle." Retina, March 20, 2024. http://dx.doi.org/10.1097/iae.0000000000004107.

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Purpose: To demonstrate a novel surgical technique that is a low-cost alternative to commercial implants for macular buckling in high myopia. Methods: A silicon encircling band serves as the anchor. A second silicon circling band is employed, with a 10mm silicon strip to widen the posterior scleral indentation. This band is inserted posteriorly the lateral and inferior rectus muscles and pushed behind the globe, orienting it in a superior-temporal to inferio-nasal position with the silicone strip directly under the macula. For better visualization, the placement of the macular buckle is done u
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34

Barile, Gaetano R., Rohun Gupta, Michael Engelbert, Talia R. Kaden, and William M. Schiff. "Nondrainage Scleral Buckling in the Modern Vitrectomy Era." Retina, February 12, 2025. https://doi.org/10.1097/iae.0000000000004428.

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Purpose: To evaluate outcomes of rhegmatogenous retinal detachment (RRD) treated with a scleral buckle (SB) without external drainage of subretinal fluid during the modern vitrectomy era. Methods: The records of 107 eyes of 107 patients that underwent treatment with nondrainage SB surgery for primary RRD with at least 3 months of follow-up were reviewed. Results: SB surgery included segmental elements (radial, 44.9%; circumferential, 23.4%) and encircling procedures (31.8%). Most (68.2%) patients were under age 60 years, and most eyes (89.7%) were phakic. Single breaks were present in 53.3% of
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35

Ha, Jeong Hyun, Jagmeet S. Arora, Jamasb J. Sayadi, et al. "Investigating orbital foreign device-associated malignancies: a scoping review." BMC Cancer 25, no. 1 (2025). https://doi.org/10.1186/s12885-024-13422-z.

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Abstract Background While prosthesis-associated malignancies have been acknowledged, awareness among surgeons and patients in the ophthalmologic field remains limited, despite the frequent occurrence of prosthesis-related surgeries. We aim to address this gap through a scoping review of malignancies following ophthalmologic surgeries involving various foreign device/prosthesis/implants. Methods Following PRISMA guidelines, we conducted a review using PubMed and Embase for studies on cancer and ophthalmic prostheses/implants. The final selection of articles for the ophthalmology aspect underwen
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Valera-Cornejo, Diego Alejandro, Marlon García-Roa, and Verónica Romero-Morales. "Surgically induced diffuse scleritis associated with choroidal detachment following phacoemulsification surgery." European Journal of Ophthalmology, June 26, 2021, 112067212110261. http://dx.doi.org/10.1177/11206721211026102.

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Purpose: We present a case of a hemorrhagic choroidal detachment associated with a surgical induced diffuse scleritis (SIDS) following phacoemulsification surgery. Case report: A-49-year-old healthy male with history of high myopia and pars-plana vitrectomy associated with 360° encircling buckle surgery years ago, who underwent phacoemulsification surgery with in-the-bag intraocular lens implantation on the right eye and developed an important 360° hemorrhagic choroidal detachment on the first-day post-surgery, 10 days later, presented SIDS. First day after surgery, best-corrected visual acuit
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