Colenbrander August
Smith-Kettlewell Eye Research Institute, San Francisco, California, USA.
Am J Ophthalmol. 2021 Apr;224:66-73. doi: 10.1016/j.ajo.2020.12.004. Epub 2020 Dec 9.
Vision is a complex phenomenon that can be addressed from different points of view. Input to the visual system consists of visual stimuli, the final output is visually guided behavior, while visual perceptions are an intermediate product. Clinicians often start by considering the input-related aspects that can be addressed by medical and surgical means. Patients, on the other hand, may be most concerned about the output aspects, that is, the effect on their daily activities. The relations between these 2 points of view are often misunderstood, which may lead to miscommunication. This perspective-based on more than 4 decades devoted to vision rehabilitation-aims at exploring these differences to bridge the communications gap. Seemingly similar tests may actually assess different aspects. One example is the relationship between letter chart acuity and reading ability, as demonstrated by the difference between Jaeger's and Snellen's tests. Clinical applications require assessment of individuals. Societal applications deal with groups of people; they include research, public health statistics, and eligibility rules for privileges or benefits. Such applications often rely on the application of formulas to input measurements to estimate the consequences on the output side. The implications of such simplifications should be understood.
视觉是一种复杂的现象，可以从不同的角度进行探讨。视觉系统的输入由视觉刺激组成，最终输出是视觉引导的行为，而视觉感知则是中间产物。临床医生通常首先考虑可以通过医学和手术手段解决的与输入相关的方面。另一方面，患者可能最关心输出方面，即对他们日常活动的影响。这两种观点之间的关系常常被误解，这可能导致沟通不畅。基于四十多年致力于视力康复的这一观点，旨在探索这些差异以弥合沟通差距。看似相似的测试实际上可能评估不同的方面。一个例子是字母表视力与阅读能力之间的关系，如耶格测试和斯内伦测试之间的差异所示。临床应用需要对个体进行评估。社会应用涉及人群；它们包括研究、公共卫生统计以及特权或福利的资格规则。此类应用通常依靠将公式应用于输入测量来估计对输出方面的影响。应该理解这种简化的含义。
