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Effect of magnification devices on dental students' visual acuity.

ABSTRACT: This study aimed to determine dental students' visual acuity and neck angulation when using magnification devices and distances from the operating field. Forty students from each of the second through fifth years of the five-year program at the School of Dentistry of Araraquara were selected (N = 160). Visual acuity was tested using a miniature Snellen eye chart under five different settings (naked eye; simple loupe; Galilean loupe; Keplerian loupe and an operating microscope). Photographs were taken during the visual acuity exam in order to evaluate the angulation of the subjects' necks in a neutral posture. The two-factor analysis of variance and the Games-Howell post-hoc test were performed (? = 0.05). A significant difference in visual acuity and neck angulation was found between the "magnification device" and "distance" factors in each of the graduating classes analyzed (p<0.05). At a standardized distance, the Keplerian loupe (535.93±133.69), the Galilean loupe (514.06±171.56), and the operating microscope (517.71±161.61) all provided greater visual acuity. At a subjectively comfortable distance, the Keplerian (521.35±157.99) and Galilean (515.00±156.32) loupes produced the best visual acuity. The angulation of the neck was greater when the simple loupes (56,59±10,88) and naked eye (56.51±13.55) were used at a subjectively comfortable distance. At both a standardized distance and a comfortable distance, the Galilean and Keplerian magnification systems provided the best visual acuity and the lowest angulation of the operator's neck. At a standardized distance of 30 cm to 40 cm, the operating microscopes produced similar results.

SUBMITTER: Wajngarten D

PROVIDER: S-EPMC6436677 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Effect of magnification devices on dental students' visual acuity.

Wajngarten Danielle D Garcia Patrícia Petromilli Nordi Sasso PPNS

PloS one 20190327 3

This study aimed to determine dental students' visual acuity and neck angulation when using magnification devices and distances from the operating field. Forty students from each of the second through fifth years of the five-year program at the School of Dentistry of Araraquara were selected (N = 160). Visual acuity was tested using a miniature Snellen eye chart under five different settings (naked eye; simple loupe; Galilean loupe; Keplerian loupe and an operating microscope). Photographs were ...[more]

PMID: 30917132

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Project description:BackgroundEndotracheal intubation by direct laryngoscopy is a mainstay of advanced airway management performed both in the prehospital environment and in the Emergency Department. Many factors may affect the quality of view during direct laryngoscopy, one of them being the visual acuity (VA) of the intubator under these demanding conditions. While some individual variation in VA is to be expected in younger populations, VA naturally deteriorates in older populations particularly beyond the age of 40 years. This study aimed to describe VA in a younger (n=19) and an older (≥40 years of age, n=20) cohort of intubators at baseline and during simulated adult laryngoscopy, and to compare VA between these two age cohorts.MethodsA baseline near VA test was done using a Sloan Early Treatment Diabetic Retinopathy Study (EDTRS) near vision chart at 40 cm under ambient indoor light. Participants in both age cohorts were then requested to perform laryngoscopy using an airway simulator at 40 cm viewing distance and again at a viewing distance of their choice. Both binocular and monocular VA were tested using a near VA chart placed anterior to the vocal cords of the airway trainer. VA was quantified using the logarithm of the minimum angle of resolution (logMAR). Differences in VA between age cohorts were assessed using independent samples t-tests and differences within age cohorts were assessed using paired samples t-tests.ResultsBinocular and monocular near VA was significantly reduced in the older cohort compared to the younger cohort at baseline (both eyes -0.129 logMAR; p = 0.04, right eye -0.147 logMAR; p = 0.005, left eye -0.197 logMAR; p = 0.002). Within each age cohort VA was significantly reduced during laryngoscopy at a fixed viewing distance (younger; both eyes -0.111 logMAR; p < 0.001, right eye -0.095 logMAR; p < 0.001, left eye -0.105 logMAR; p < 0.001; older; both eyes -0,08 logMAR; p < 0.001, right eye -0.110 logMAR; p < 0.001, left eye -0.065 logMAR; p = 0.01) but this was improved by reducing viewing distance.ConclusionIncreased age was associated with a significant reduction in VA at baseline and during laryngoscopy, which can be partially compensated for by adjusting viewing distance. Although it is currently unknown to what extent this age-related reduction of VA might negatively affect time to place an endotracheal tube or success of placement under direct vision, older intubators should be aware of this effect and consider specialized corrective eyewear in order to maintain an adequate level of VA.

Dataset Information

Effect of magnification devices on dental students' visual acuity.

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Effect of magnification devices on dental students' visual acuity.

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