This protocol includes a test of visual acuity. Why?
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Last September and October (2020) when those presenting with "long-term" COVID-19 responded to our questionnaire, "blurred vision" was one possible choice in communicating a respondent's symptoms.
In the criteria for inclusion in this study, symptoms from that prior questionnaire have been selected based on response frequencies. In making that selection, the focus was on symptoms found in at least 50% of respondents.
Those who responded that they had "blurred vision" before COVID-19, early in the course of infection, during most of the illness, and/ or 'currently' (meaning, on the day they responded to the questionnaire) represented the following frequencies:
Blurred vision:
Before COVID-19 3.05%
Early in course 21.32%
During COVID-19 32.35%
Currently (?'naire) 30.37%
Early, during, currently 15.11%
Early & During 16.55%
During & Currently 23.02%
Some reported having "blurred vision" already before COVID-19. But that response was very infrequent (3%).
Although below the 50% frequency cutoff applied to other parts of this protocol,
we think that finding that almost a third of respondents noticed a change in vision during heir illness is important.
It needs pursuit, and in an objective manner.
Another key point is that these questionnaire responses were subjective.
Visual acuity due to COVID-19 might have changed gradually, or slightly during "long-term" COVID-19, but ophthalmologists know quite well that a person's impression, and the data from an objective test of vision, do not always match up closely. That's why prescriptions for glasses get changed from time to time.
Perhaps a person feeling short of breath, with palpitations, headaches and dizziness could be expected to notice less, subtle visual changes.
So for at least that reason (obtaining an objective test of visual acuity in the setting of COVID-19) such a test has been included in this present protocol.
Another reason to include this, is for another finding that we think is exciting.
Quickly summarized, red light and near-infrared light in the wavelength and field strength (energy density) range that are applied in this study, have and continue to be extensively studied for positive effects on the eye. For that matter, positive effects on optic nerve and brain as well.
We'll present that information here with links to pertinent articles from the related literature. We'll annotate each briefly, to allow the reader to continue making progress and avoid getting submerged. It is a quite complete and complex field in and of itself and at many levels: brain, optic nerves, retina, and specialized cells such as Müller glial cells (explained elsewhere) that also respond to the energies from red light.
Of course, if one goes in for an eye check, "they" check your eyes, give you the results or send them to your doctor.
Some machines and smartphone apps now allow one to do that away from the optometrist.
In our present protocol, enrollees are frequently on their own.
So we have evolved a viable method that allows one to do the test appropriately, on one's own, and get meanigful results. Including of course, transmitting these to Study Central to receive and care for the results of the effort.
If any change in visual acuity takes place during this study, it shoud be possible to identify it. You'll see that process, presented in a DEMO as have been other parts of the study.
The already described intervention with light that passes over the head, also passes over the right eye (at point 6 in the path) and the left eye (at point 18). Although a participant's eyelid is kept normally closed during this intervention, some light will certainly get through to the retina, and the light-sensitive Müller cells. So to see if there is an effect on "blurred vision" in those with "long-term" COVID-19, or not, a test of visual acuity will be "auto-performed" on the "Full Test" Days: 1, 11, 21, 31. It's very quick.
Is this safe?
We think so. And as mentioned elsewhere, in other pertinent research endeavors, the same light wavelengths and energy densities are used with proven healing and reparative effects.
But these effects are very frequency or wavelength specific. Blue and even white light can and do damage to eyes.
So let's stay in the red.
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