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Resumen Propósito: El presente estudio tiene como objetivo explorar la bibliografía existente sobre las habilidades y movimientos visuales en jugadores de tenis. Metodología: Se indagó en las bases de datos Scopus, SPORTDiscus, PubMed y Google Scholar que permn seleccionar 37 estudios empíricos realizados con un método cuantitativo. La elección de los estudios respondió a los criterios establecidos en torno a las palabras clave, temática del estudio y la metodología de investigación. Resultados: Los resultados se organizan en tres tópicos centrales: (a) Antecedentes de habilidades visuales en el siglo XX, (b) Siglo XXI: rol de los movimientos sacádicos y (c) Reflexiones sobre la gesta tenística y los movimientos sacádicos. Conclusiones: A lo largo de varias décadas de investigación y seguimiento al enfoque ''visión y deporte'' en el tenis de campo, específicamente en los movimientos visuales entre fijaciones y movimientos sacádicos, se pueden identificar niveles diferenciales de rendimiento tenístico con el potencial de ser indicadores de mejores desempeños deportivos. Dado que las herramientas utilizadas hasta ahora en esta disciplina para los procesos de selección o evaluación no son determinantes, debido a ser una disciplina deportiva multifactorial de orden perceptivo-motor y de habilidades abiertas, se sugiere que las habilidades visuales pueden ser indispensables para la adquisición de un alto nivel competitivo. Este aspecto plantea una línea de investigación interesante que merece una mayor exploración en el futuro.

Abstract: Purpose: The presente study aims to explore the existing bibliography on visual skills and visual movements in tennis players. Method: We searched the Scopus, SPORTDiscus, PubMed and Google Scholar databases, which allowed us to select 37 empirical studies carried out with a quantitative method. The choice of the studies responded to the criteria established around the Keywords, the subject of the study and the research methodology. Results: The results are organized into three central topics: (a) Antecedents of visual skills in the 20th century, (b) 21st century: Role of saccadic movements, and (c) Reflections on the tennis feat and saccadic movements. Conclusions: Throughout several decades of research and monitoring of the ''vision and sport'' approach in field tennis, specifically in the visual movements between fixations and saccadic movements, differential levels of tennis performance can be identified with the potential to be indicators of better sports performance. Given that the tools used so far in this discipline for the selection and/or evaluation processes are not determinant, due to being a multifactorial sport discipline of perceptual-motor order and open skills, it is suggested that visual skills may be essential for the acquisition of a high competitive level. This aspect raises an interesting line of research that deserves further exploration in the future.

Resumo: Propósito: O presente estudo tem como objetivo explorar a literatura existente sobre habilidades e movimentos visuais em jogadores de tênis. Metodologia: Pesquisamos os bancos de dados Scopus, SPORTDiscus, PubMed e Google Scholar, o que nos permitiu selecionar 37 estudos empíricos realizados com um método quantitativo. A escolha dos estudos atendeu aos critérios estabelecidos em torno das palavras-chave, do tema do estudo e da metodologia da pesquisa. Resultados: Os resultados estão organizados em três tópicos centrais: (a) Precedentes das habilidades visuais no século XX, (b) Século XXI: Papel dos movimentos sacádicos (c) Reflexões sobre a proeza do tênis e os movimentos sacádicos. Conclusões: Ao longo de várias décadas de pesquisa e monitoramento da abordagem ''visão e esporte'' no tênis de campo, especificamente nos movimentos visuais entre fixações e movimentos sacádicos, podem ser identificados níveis diferenciais de desempenho no tênis com potencial para serem indicadores de melhores desempenhos esportivos. Considerando que as ferramentas utilizadas até o momento nessa modalidade para os processos de seleção e/ou avaliação não são determinantes, devido ao fato de ser uma modalidade esportiva multifatorial de ordem perceptivomotora e de habilidades abertas, sugere-se que as habilidades visuais podem ser essenciais para a aquisição de um alto nível competitivo. Esse aspecto levanta uma linha de pesquisa interessante que merece ser mais explorada no futuro.

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BACKGROUND: Premature newborns have a higher risk of abnormal visual development and visual impairment. OBJECTIVE: To develop a computational methodology to help assess functional vision in premature infants by tracking iris distances. METHODS: This experimental study was carried out with children up to two years old. A pattern of image capture with the visual stimulus was proposed to evaluate visual functions of vertical and horizontal visual tracking, visual field, vestibulo-ocular reflex, and fixation. The participants' visual responses were filmed to compose a dataset and develop a detection algorithm using the OpenCV library allied with FaceMesh for the detection and selection of the face, detection of specific facial points and tracking of the iris positions is done. A feasibility study was also conducted from the videos processed by the software. RESULTS: Forty-one children of different ages and diagnoses participated in the experimental study, forming a robust dataset. The software resulted in the tracking of iris positions during visual function evaluation stimuli. Furthermore, in the feasibility study, 8 children participated, divided into Pre-term and Term groups. There was no statistical difference in any visual variable analyzed in the comparison between groups. CONCLUSION: The computational methodology developed was able to track the distances traveled by the iris, and thus can be used to help assess visual function in children.

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Background: Wyburn-Mason syndrome is a rare, non-hereditary congenital disease, belonging to the group of neurocutaneous syndromes with fewer than 100 cases reported since its first description in 1937. Case report: A young adult man was initially evaluated at the age of 2 years for proptosis and progressive visual impairment of the right eye, followed by impairment in ocular abduction, adduction and elevation as well as amaurosis. MRI revealed an expansive formation centred in the right orbit compromising conal spaces with distortion of eye muscles and optic nerve. The lesion extended through the superior orbital fissure into the right cavernous sinus and to the contralateral orbit. Despite embolisation, proptosis and oedema of the periorbital tissue continued to worsen. The combination of facial, ocular and intracranial vascular malformations and the exclusion of alternative aetiologies led to a diagnosis of cerebrofacial arteriovenous metameric syndrome (CAMS) 1 (Wyburn-Mason syndrome). Discussion: Important differential diagnoses are other CAMS, such as Sturge-Weber syndrome, as well as other conditions such as retinal cavernous haemangioma and vasoproliferative tumours. The optimal treatment regimen for severe cases of this syndrome is still unclear. Wyburn-Mason syndrome should be considered in patients presenting multiple arteriovenous malformations with orbital apex lesions.

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ABSTRACT Purpose: This study aimed to evaluate the mechanisms of injury and types of orbital fractures and their relation to concurrent commotio retinae. Methods: This retrospective study evaluated the records of patients with orbital fractures whose diagnoses had been confirmed by computer tomography between July 2017 and September 2019. Patient demographics, the circumstances of injury, ophthalmic examination results, and radiological findings were tabulated. Statistical analysis of the data used two-tailed student's t-tests, chi-squared tests, and odds ratio calculations. Statistical significance was set at p<0.05. Results: Of the 204 patients with orbital fractures included in this study, 154 (75.5%) were male. The mean age was 42.1 years. Orbital fractures involving one orbital wall (58.8%) were more common than those affecting multiple walls (41.2%). The majority of fractures affected the inferior wall (60.3%), with the medial walls being the next most frequently affected (19.6%). The most common cause of injury was assault (59.3%), and the second most common was falls (24%). Commotio retinae was observed in 20.1% of orbital fracture cases and was most associated with injuries caused by assault (OR=5.22, p<0.001) and least associated with those caused by falls (OR=0.06, p<0.001). Eye movement restrictions were more common in central than peripheral commotio (OR=3.79, p=0.015) and with medial wall fractures than fractures to other orbital walls (OR=7.16, p<0.001). The odds of commotio were not found to be higher in patients with multi-walled orbital fractures than in those with single-walled fractures (p=0.967). Conclusions: In the study population, assault was the most common cause of orbital fractures and resulted in commotio retinae than other causes. Ophthalmologists should be aware of the likelihood of commotio retinae in patients with orbital fractures resulting from assault, regardless of the extent of the patient's injuries.

RESUMO Objetivo: Este estudo visou avaliar os mecanismos da lesão e os tipos de fraturas orbitárias e sua relação com commotio retinae simultânea. Métodos: Este estudo retrospectivo avaliou registros de pacientes com fraturas orbitárias cujos diagnósticos foram confirmados por tomografia computadorizada entre julho de 2017 e setembro de 2019. Foram registrados os dados demográficos, circunstâncias da lesão, os resultados do exame oftalmológico e achados radiológicos. A análise estatística dos dados usou os testes de t-Student bicaudal, qui-quadrado e cálculos de odds ratio. O significado estatístico foi fixada em p<0,05. Resultados: Dos 204 pacientes com fraturas orbitárias incluídos neste estudo, 154 (75,5%) eram sexo masculino (75,5%). A média de idade foi de 42,1 anos. As fraturas orbitárias envolvendo uma parede orbital (58,8%) foram mais comuns do que as que acometeram várias paredes (41,2%). A maioria das fraturas acometeu a parede inferior (60,3%), sendo as paredes mediais as próximas mais frequentemente afetadas (19,6%). A causda mais comum de lesão foi agressão (59,3%), e a segunda mais comum foi queda (24%). A commotio retinae foi observada em 20,1% dos casos de fratura orbital e foi mais associada a lesões causadas por agressão (OR=5,22, p<0,001) e menos associada com aquelas causadas por quedas (OR=0,06, p<0,001). As restrições de movimentos oculares eram mais comuns na comoção central do que na periférica (OR=3,79, p=0,015) e com fraturas da parede medial do que com fraturas de outras paredes orbitais (OR=7,16, p<0,001). As chances de comoção não foram maiores em pacientes com fraturas orbitais de paredes múltiplas do que naqueles com fraturas de parede simples (p=0,967). Conclusões: Na população do estudo, a agressão foi a causa mais comum de fraturas orbitais e resultou em commotio retinae mais grave do que qualquer outra causa. Os oftalmologistas devem estar cientes da probabilidade de commotio retinae em pacientes com fraturas orbitais resultantes de agressão, independentemente da extensão das lesões do paciente.

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ABSTRACT Purpose: To evaluate the saccadic movements of patients with visual field loss due to primary open-angle glaucoma. Methods: Thirteen patients with good visual acuity (0.2 logMAR or better) (seven patients with primary open-angle glaucoma 65 ± 13 years) and six controls (51 ± 6 years) yielded a comprehensive ophthalmological examination, including Humphrey Visual Field tests (SITA-Standard 24-2), and performed a monocular, exploratory digital visual search task that quantifies the duration for finding the number "4" on a random array of digits distributed on the screen. After individual adjustments of the angle and distance positioning, the screen was spatially matched with the 24-2 visual field, and divided into five areas for analysis. During the task, saccades were simultaneously recorded in the same eye with a video-based eye tracker. Results: The patients with primary open-angle glaucoma showed a significantly higher number of saccades/screen (median ± interquartile range, 59.00 ± 29.00 vs. 32.50 ± 19.75 saccades (p=0.027) and visual search time per screen (38.50 ± 60.14 vs. 23.75 ± 8.90 seconds (p=0.035) than the controls did. Although the univariate analysis indicated a significant correlation with visual field mean deviation (coefficient=26.19 (p=0.02), only the visual search time/screen was significantly associated with the number of saccades/screen in the multivariate regression model (coefficient=0.55 (p<0.001). Overall, no significant correlation was observed between the sectorial number of saccades and the sensitivity of the five visual field areas. Conclusions: The patients with primary open-angle glaucoma show impaired search performance and showed a higher number of saccades needed to find stimuli when performing the exploratory visual task.

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Reliable, noninvasive biomarkers that reveal the internal state of a subject are an invaluable tool for neurological diagnoses. Small fixational eye movements, called microsaccades, are a candidate biomarker thought to reflect a subject's focus of attention [Z. M. Hafed, J. J. Clark, VisionRes. 42, 2533-2545 (2002); R. Engbert, R. Kliegl, VisionRes. 43, 1035-1045 (2003)]. The linkage between the direction of microsaccades and attention has mainly been demonstrated using explicit and unambiguous attentional cues. However, the natural world is seldom predictable and rarely provides unambiguous information. Thus, a useful biomarker must be robust to such changes in environmental statistics. To determine how well microsaccades reveal visual-spatial attention across behavioral contexts, we analyzed these fixational eye movements in monkeys performing a conventional change detection task. The task included two stimulus locations and variable cue validities across blocks of trials. Subjects were adept at the task, showing precise and graded modulations of visual attention for subtle target changes and performing better and faster when the cue was more reliable [J. P. Mayo, J. H. R. Maunsell, J. Neurosci. 36, 5353 (2016)]. However, over tens of thousands of microsaccades, we found no difference in microsaccade direction between cued locations when cue variability was high nor between hit and miss trials. Instead, microsaccades were made toward the midpoint of the two target locations, not toward individual targets. Our results suggest that the direction of microsaccades should be interpreted with caution and may not be a reliable measure of covert spatial attention in more complex viewing conditions.

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It has been proposed that eye movements could be related to glaucoma development. This research aimed to compare the impact of intraocular pressure (IOP) versus horizontal duction on optic nerve head (ONH) strains. Thus, a tridimensional finite element model of the eye including the three tunics of the eye, all of the meninges, and the subarachnoid space (SAS) was developed using a series of medical tests and anatomical data. The ONH was divided into 22 subregions, and the model was subjected to 21 different eye pressures, as well as 24 different degrees of adduction and abduction ranging from 0.5° to 12°. Mean deformations were documented along anatomical axes and in principal directions. Additionally, the impact of tissue stiffness was assessed. The results show no statistically significant differences between the lamina cribrosa (LC) strains due to eye rotation and IOP variation. However, when assessing LC regions some experienced a reduction in principal strains following a 12° duction, while after the IOP reached 12 mmHg, all LC subzones showed an increase in strains. From an anatomical perspective, the effect on the ONH following 12° duction was opposite to that observed after a rise in IOP. Moreover, high strain dispersion inside the ONH subregions was obtained with lateral eye movements, which was not observed with increased IOP and variation. Finally, SAS and orbital fat stiffness strongly influenced ONH strains during eye movements, while SAS stiffness was also influential under ocular hypertension. Even if horizontal eye movements cause large ONH deformations, their biomechanical effect would be markedly distinct from that induced by IOP. It could be predicted that, at least in physiological conditions, their potential to cause axonal injury would not be so relevant. Thus, a causative role in glaucoma does not appear likely. By contrast, an important role of SAS would be expectable.

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PURPOSE: The purpose of this research is to propose a new method for the easy, inexpensive and objective quantification of nystagmus using eye-tracking records collected during a simple reading task that could be implantable in clinical practice to assess patients with nystagmus. METHODS: This is a prospective, observational pilot study. Eye movements of 4 nystagmus patients and 9 healthy children during a reading task (a paragraph with 82 words) on a 15'' monitor were collected and compared. Data are time series indicating the gaze position on the screen. Two quantifiers were proposed: IndS (based on the speed of movements) and IndF (based on the variation of the gaze trajectory). RESULTS: The indices proposed reflect differences in the behavior of eye movements between the two groups. Nystagmus patients present higher values of IndS - indicating smaller number of slow movements (16% of movements with speeds <0.33 1/s for nystagmus and 85% for the control group, with p = 0.01) - and higher values of IndF - indicating higher gaze fluctuation (p = 0.01). Differences were not related with reading speed as show the mean and standard deviation: the nystagmus group required 115±45 s to complete the task and the control group 151±85 s; p = 0.73. CONCLUSIONS: The proposed indices provide a new method that allows an objective assessment of nystagmus, with potential use in clinical and research practice to improve the follow-up of patients by monitoring the nystagmus over time or treatment.

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ABSTRACT Purpose to verify the occurrence of visual symptoms in subjects with dizziness after stroke, to compare the posturographic results and to correlate their clinical aspects with the characteristics of the stroke. Methods This is an observational, cross-sectional study with quantitative analysis. The inclusion criteria for the sample composition were to report dizziness after ischemic or hemorrhagic stroke and at least 18 years old. We evaluated 50 patients through clinical anamnesis and Dynamic Foam-Laser Posturography. Anteroposterior deviations were calculated with the measures of each SOT. The preferences of the functions were analyzed according to the means of the Sensory Organization Test. Results twenty-eight subjects had stroke-related visual symptoms. The prevalent kind of dizziness was imbalance and the most frequent stroke was ischemic, mainly in the carotid territory. The values of tests were below the standard; there was a relationship between older subjects and proprioceptive system, and between visual preference and presence of visual symptoms, as well as the location of the posterior stroke. Conclusion there was a high frequency of visual symptoms among subjects with stroke sequelae and these have significant relationship with the worst values in visual preference system.

RESUMO Objetivo verificar a ocorrência de sintomas visuais em sujeitos com tontura após Acidente Vascular Cerebral (AVC), comparar os resultados posturográficos e relacionar seus aspectos clínicos com as características do AVC. Método Trata-se de um estudo observacional, transversal, com análise quantitativa. Os critérios de inclusão para composição da amostra foi ter tontura após o AVC isquêmico ou hemorrágico e ter pelo menos 18 anos de idade. Foram avaliados 50 sujeitos por meio de anamnese clínica e os testes da Posturografia Dinâmica Foam Laser. Os desvios anteroposteriores foram calculados de acordo com as médias do Teste de Organização Sensorial. Resultados Vinte e oito sujeitos apresentaram sintomas visuais após o AVC. O desequilíbrio foi o tipo de tontura prevalente e o AVC isquêmico o mais comum, sobretudo no território carotídeo. Os resultados dos testes foram inferiores ao padrão de referência; houve relação com sujeitos mais velhos e o sistema proprioceptivo, e entre o sistema de preferência visual e a presença dos sintomas visuais, bem como com o AVC da circulação posterior. Conclusão Houve alta frequência de sintomas visuais entre os sujeitos com sequelas de AVC com relação significativa com piores valores da preferência visual.

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ABSTRACT Objective: To evaluate if participants, subjected to whole-body vibration, two different types of media (paper versus tablet) and two lighting environments (fluorescent versus LED), present a difference in eye-movement parameters during reading tasks. Methods: Fourteen adults silently read two different texts in each one of the eight randomized testing conditions (whole-body vibration versus media versus lighting), resulting in 16 different texts read per individual. Whole-body vibration was applied in the vertical direction, 5Hz and 0.8 m/s2 root-mean-square amplitude, a condition similar to those experienced by forklift truck drivers. Participants were in a sitting position with a backrest. An eye-tracker evaluated the eye-movements during the reading task. Results: Whole-body vibration significantly reduced the number of ocular fixations, and cross-correlation; and increased the reading efficiency, fixation duration, directional attack, and binocular anomalies. Neither the type of media nor the lighting environment interfered significantly with the eye-movements, both in situations with and without vibration. Conclusion: The results indicate that whole-body vibration interfered in the eye-movements during the reading task. This may impose a difficulty to process the visual information and to synchronously coordinate the binocular movements under vibration environments.

RESUMO Objetivo: Avaliar se participantes submetidos à vibração de corpo inteiro, a dois tipos diferentes de mídia (papel versus tablet) e a dois ambientes de iluminação (fluorescente versus LED) apresentam diferença nos parâmetros de movimento dos olhos durante tarefas de leitura. Métodos: Quatorze adultos leram silenciosamente dois textos diferentes em cada uma das oito condições de teste (vibração de corpo inteiro versus mídia versus iluminação), de forma aleatória, resultando em 16 textos diferentes lidos por indivíduo. A vibração de corpo inteiro foi aplicada no sentido vertical, com amplitude de 5Hz e 0,8m/s² da raiz do valor quadrático médio, em condição semelhante às vivenciadas pelos motoristas de empilhadeiras. Os participantes permaneceram em postura sentada com encosto. Um rastreador ocular avaliou os movimentos oculares durante a leitura. Resultados: A vibração de corpo inteiro reduziu significativamente o número de fixações oculares e a correlação cruzada entre os olhos e aumentou a eficiência de leitura, duração da fixação, ataque direcional e anomalias binoculares. Nem o tipo de mídia nem as condições de ambientes de iluminação interferiram significativamente nos movimentos oculares, tanto em situações com ou sem vibração. Conclusão: Os resultados indicam que a Vibração de Corpo Inteiro pode interferir nos movimentos oculares durante a leitura. Isso pode impor uma dificuldade no processamento da informação visual e na coordenação síncrona dos movimentos binoculares em ambientes de vibração.

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