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Fundus Signs in Temporal Arteritis
Br J Ophthalmol: first published as 10.1136/bjo.62.9.591 on 1 September 1978. Downloaded from British Journal of Ophthalmology, 1978, 62, 591-594 Fundus signs in temporal arteritis D. McLEOD, E. 0. OJI, E. M. KOHNER, AND J. MARSHALL From Moorfields Eye Hospital and Institute of Ophthalmology, London SUMMARY A patient with temporal arteritis developed a variety of ischaemic lesions in the eyes. Infarction of the inner retina and optic nerve head was delineated on presentation by white swelling in the retinal nerve fibre layer. The role of interrupted axoplasmic transport in the production of this sign is discussed. Outer retinal infarction was also noted on presentation and subsequently gave rise to striking pigmented scars. Temporal arteritis often presents with visual loss, the central venous tributaries were of normal and necropsy examination in such cases shows wide- calibre and colour. No abnormality of the inner spread disease of the ophthalmic artery and the retina was noted in the territory of supply of the extraocular course of its ciliary and retinal branches central retinal artery. (Henkind et al., 1970). The medial and lateral At first sight the left eye showed a similar ophthal- posterior ciliary arteries supply the optic nerve head, moscopic picture, with pale swelling of the nasal the outer retina, and, in 20 to 50% of individuals, part of the optic disc and a row of fluffy white by copyright. a variable area of inner retina contiguous with the cotton-wool spots crossing the papillomacular optic disc (Hayreh, 1969); the central retinal artery bundle (Fig. 2). -
Genes in Eyecare Geneseyedoc 3 W.M
Genes in Eyecare geneseyedoc 3 W.M. Lyle and T.D. Williams 15 Mar 04 This information has been gathered from several sources; however, the principal source is V. A. McKusick’s Mendelian Inheritance in Man on CD-ROM. Baltimore, Johns Hopkins University Press, 1998. Other sources include McKusick’s, Mendelian Inheritance in Man. Catalogs of Human Genes and Genetic Disorders. Baltimore. Johns Hopkins University Press 1998 (12th edition). http://www.ncbi.nlm.nih.gov/Omim See also S.P.Daiger, L.S. Sullivan, and B.J.F. Rossiter Ret Net http://www.sph.uth.tmc.edu/Retnet disease.htm/. Also E.I. Traboulsi’s, Genetic Diseases of the Eye, New York, Oxford University Press, 1998. And Genetics in Primary Eyecare and Clinical Medicine by M.R. Seashore and R.S.Wappner, Appleton and Lange 1996. M. Ridley’s book Genome published in 2000 by Perennial provides additional information. Ridley estimates that we have 60,000 to 80,000 genes. See also R.M. Henig’s book The Monk in the Garden: The Lost and Found Genius of Gregor Mendel, published by Houghton Mifflin in 2001 which tells about the Father of Genetics. The 3rd edition of F. H. Roy’s book Ocular Syndromes and Systemic Diseases published by Lippincott Williams & Wilkins in 2002 facilitates differential diagnosis. Additional information is provided in D. Pavan-Langston’s Manual of Ocular Diagnosis and Therapy (5th edition) published by Lippincott Williams & Wilkins in 2002. M.A. Foote wrote Basic Human Genetics for Medical Writers in the AMWA Journal 2002;17:7-17. A compilation such as this might suggest that one gene = one disease. -
Physical Assessment of the Newborn: Part 3
Physical Assessment of the Newborn: Part 3 ® Evaluate facial symmetry and features Glabella Nasal bridge Inner canthus Outer canthus Nasal alae (or Nare) Columella Philtrum Vermillion border of lip © K. Karlsen 2013 © K. Karlsen 2013 Forceps Marks Assess for symmetry when crying . Asymmetry cranial nerve injury Extent of injury . Eye involvement ophthalmology evaluation © David A. ClarkMD © David A. ClarkMD © K. Karlsen 2013 © K. Karlsen 2013 The S.T.A.B.L.E® Program © 2013. Handout may be reproduced for educational purposes. 1 Physical Assessment of the Newborn: Part 3 Bruising Moebius Syndrome Congenital facial paralysis 7th cranial nerve (facial) commonly Face presentation involved delivery . Affects facial expression, sense of taste, salivary and lacrimal gland innervation Other cranial nerves may also be © David A. ClarkMD involved © David A. ClarkMD . 5th (trigeminal – muscles of mastication) . 6th (eye movement) . 8th (balance, movement, hearing) © K. Karlsen 2013 © K. Karlsen 2013 Position, Size, Distance Outer canthal distance Position, Size, Distance Outer canthal distance Normal eye spacing Normal eye spacing inner canthal distance = inner canthal distance = palpebral fissure length Inner canthal distance palpebral fissure length Inner canthal distance Interpupillary distance (midpoints of pupils) distance of eyes from each other Interpupillary distance Palpebral fissure length (size of eye) Palpebral fissure length (size of eye) © K. Karlsen 2013 © K. Karlsen 2013 Position, Size, Distance Outer canthal distance -
The American Ophthalmological Society 2019
Transactions of the American Ophthalmological Society VOLUME CXVII ONE HUNDRED AND FIFTY-FIFTH ANNUAL MEETING The Greenbrier, White Sulphur Springs, West Virginia 2019 PUBLISHED FOR THE AMERICAN OPHTHALMOLOGICAL SOCIETY SAN FRANCISCO, CALIFORNIA 2019 TABLE OF CONTENTS ABSTRACTS Papers ..............................................................................................................................................................2 Posters .............................................................................................................................................................3 2018-2019 Theses Published in the AJO .......................................................................................................4 ACADEMY OF OPHTHALMOLOGY Officers and Council .......................................................................................................................................6 Presidents of the Society ............................................................................................................................... 7 AWARDS AND LECTURES Recipients of the Lucien Howe Medal ...........................................................................................................8 Frederick H. Verhoeff Lecturers .....................................................................................................................9 Frederick Blodi Lecturers ...............................................................................................................................9 -
Systemic Disease with a Twist of Neuro
6/14/2021 Systemic Disease Straight Up…. AOA’s definition of Optometry approved Sept 2012 with a Twist of Neuro! Doctors of optometry (ODs) are the independent primary health care Beth A. Steele, OD, FAAO professionals for the eye. Optometrists examine, diagnose, treat, and [email protected] manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. PREVENTION Not just this… TREATING THE WHOLE PATIENT But also this… MEDICAL OPTOMETRY …..where do we fit in? 1 6/14/2021 29 AA F Hx ESRD, on dialysis Blood Pressure Classifications and Referral Guidelines (adapted from the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure –JNC 7, no symptoms, visual or systemic 2003) Hypotension normal Pre‐ HTN Stage 1Stage 2 Critical High Point Systolic < 90 < 120 120‐139 140‐ 159 ≥160 >180 Diastolic < 60 < 80 80 ‐ 89 90‐99 ≥100 >110 Refer Refer Evaluate or refer From: 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members within 2 within 1 immediately or BP 159/116 Appointed to the Eighth Joint National Committee (JNC 8) months month within 1 week JNC vs. ACC/AHA Guidelines All values ~10mmHg lower than JNC • 2017 ACC/AHA Clinical Practice Guidelines lowered thresholds by 10mmHg for diagnosis and treatment goals! • 26% increase in US prevalence HTN • Very controversial 2 6/14/2021 Atherosclerotic cardiovascular disease (ASCVD) risk calculator • 10‐year risk of CVD • http://tools.acc.org/ASCVD‐Risk‐Estimator/ • age >65 • atherosclerosis or risk of developing it (e.g. -
Retina/Vitreous 2017-2019
Academy MOC Essentials® Practicing Ophthalmologists Curriculum 2017–2019 Retina/Vitreous *** Retina/Vitreous 2 © AAO 2017-2019 Practicing Ophthalmologists Curriculum Disclaimer and Limitation of Liability As a service to its members and American Board of Ophthalmology (ABO) diplomates, the American Academy of Ophthalmology has developed the Practicing Ophthalmologists Curriculum (POC) as a tool for members to prepare for the Maintenance of Certification (MOC) -related examinations. The Academy provides this material for educational purposes only. The POC should not be deemed inclusive of all proper methods of care or exclusive of other methods of care reasonably directed at obtaining the best results. The physician must make the ultimate judgment about the propriety of the care of a particular patient in light of all the circumstances presented by that patient. The Academy specifically disclaims any and all liability for injury or other damages of any kind, from negligence or otherwise, for any and all claims that may arise out of the use of any information contained herein. References to certain drugs, instruments, and other products in the POC are made for illustrative purposes only and are not intended to constitute an endorsement of such. Such material may include information on applications that are not considered community standard, that reflect indications not included in approved FDA labeling, or that are approved for use only in restricted research settings. The FDA has stated that it is the responsibility of the physician to determine the FDA status of each drug or device he or she wishes to use, and to use them with appropriate patient consent in compliance with applicable law. -
Eye Findings in Dermatologic Conditions
FAST FACTS FOR BOARD REVIEW Series Editor: William W. Huang, MD, MPH Eye Findings in Dr. O’Neill is from Buffalo Medical Group, New York. The author reports no conflict of interest. Dermatologic Conditions Jenna O’Neill, MD Eye Finding Definition/Pathogenesis Dermatologic Condition(s) Miscellaneous Angioid streaks Rupture of Bruch membrane PXE, EDS (kyphoscoliosis and Associated with sickle cell (innermost layer of choroid); vascular types most commonly anemia, β thalassemia, broad red-brown lines associated), Cowden disease Paget disease of bone, radiating from optic nerve and phosphatemia; often idiopathic Ankyloblepharon Fusion of all or part of Hay-Wells syndrome (also AD mutation in p63 filiforme adnatum eyelid margins known as AEC syndrome, a form of ectodermal dysplasia) Blue sclerae Blue hue is due to Alkaptonuria, EDS, Fanconi EDS type 6 underlying choroidal veins, anemia, Marfan syndrome, (kyphoscoliosis; AR which show through thin nevus of Ota, osteogenesis mutation in PLOD, collagen fibers of sclera imperfecta types I–III, PXE which encodes lysyl hydroxylase): blue sclerae, retinal detachment, globe rupture, keratoconus; also found in alkaptonuria and nevus of Ota due to pigment deposition in sclera Brushfield spot White to gray spots at Down syndrome Normal in children periphery of iris due to (Kunkmann-Wolffian stromal hyperplasia bodies) Cherry red spot Bright red-orange color of Hurler disease, Also seen in central retinal fovea is contrasted against Niemann-Pick disease, artery occlusion (fovea pale color of retina due -
A Dictionary of Neurological Signs.Pdf
A DICTIONARY OF NEUROLOGICAL SIGNS THIRD EDITION A DICTIONARY OF NEUROLOGICAL SIGNS THIRD EDITION A.J. LARNER MA, MD, MRCP (UK), DHMSA Consultant Neurologist Walton Centre for Neurology and Neurosurgery, Liverpool Honorary Lecturer in Neuroscience, University of Liverpool Society of Apothecaries’ Honorary Lecturer in the History of Medicine, University of Liverpool Liverpool, U.K. 123 Andrew J. Larner MA MD MRCP (UK) DHMSA Walton Centre for Neurology & Neurosurgery Lower Lane L9 7LJ Liverpool, UK ISBN 978-1-4419-7094-7 e-ISBN 978-1-4419-7095-4 DOI 10.1007/978-1-4419-7095-4 Springer New York Dordrecht Heidelberg London Library of Congress Control Number: 2010937226 © Springer Science+Business Media, LLC 2001, 2006, 2011 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. -
Non-Diabetic Retinal Vascular Disease”
“Non-Diabetic Retinal Vascular Disease” Brad Sutton, O.D., F.A.A.O. Clinical Professor IU School of Optometry Indianapolis Eye Care Center Retinal Vascular Disease No financial disclosures Hypoperfusion Syndrome Occurs when the eye lacks blood perfusion secondary to carotid artery blockage or ophthalmic artery blockage. Terminology debate: venous stasis retinopathy vs. hypoperfusion syndrome Why is venous stasis retinopathy a poor term for this condition? Hypoperfusion Syndrome Patient may complain of dull, chronic ache in the affected eye Photostress issues / dazzle TIA symptoms may or may not be present (amaurosis fugax) Possible bruit / decreased pulse strength in carotid Hypoperfusion Syndrome Bruit at 30-85% blockage; swishing sound Bell vs. diaphragm Definitive diagnosis requires carotid imaging Hypoperfusion Syndrome Peripheral dot / blot hemorrhages Dilated veins Relatively spares the posterior pole Ocular Ischemic Syndrome With ocular NVD / NVE / NVI ischemic Iritis syndrome same Sluggish pupil findings plus……….. Conjunctival congestion Corneal Edema 80% unilateral / 20% bilateral Ocular Ischemic Syndrome Rare! Only 10% of eyes with 70+% blocked carotids 60% CF or worse VA by one year: 82% if NVI is present Teichopsia: colored afterimages after viewing lights More likely in patients with increased homocysteine and CRP Ocular Ischemic Syndrome When presented with Question about TIA these ocular findings……. Check carotids Arrange for carotid testing (Doppler has limits) ESR C-reactive protein CBC Ocular Ischemic Syndrome Treatment: Systemic management (diet, drugs, surgery) PRP / cryotherapy? Avastin / Lucentis / Eyelea? Five year mortality rate of 40% Sickle Cell Retinopathy Hemoglobinopathy affecting mostly AA (8% in US carry trait, .15% have SS dis.) 60,000 in US: 250,000 born yearly w-wide Malaria and natural selection (sickle trait carriers and sickle cell patients are resistant to malaria) AC, SA, SS, Sthal, SC. -
Ocular Manifestations of Inherited Diseases Maya Eibschitz-Tsimhoni
10 Ocular Manifestations of Inherited Diseases Maya Eibschitz-Tsimhoni ecognizing an ocular abnormality may be the first step in Ridentifying an inherited condition or syndrome. Identifying an inherited condition may corroborate a presumptive diagno- sis, guide subsequent management, provide valuable prognostic information for the patient, and determine if genetic counseling is needed. Syndromes with prominent ocular findings are listed in Table 10-1, along with their alternative names. By no means is this a complete listing. Two-hundred and thirty-five of approxi- mately 1900 syndromes associated with ocular or periocular manifestations (both inherited and noninherited) identified in the medical literature were chosen for this chapter. These syn- dromes were selected on the basis of their frequency, the char- acteristic or unique systemic or ocular findings present, as well as their recognition within the medical literature. The boldfaced terms are discussed further in Table 10-2. Table 10-2 provides a brief overview of the common ocular and systemic findings for these syndromes. The table is organ- ized alphabetically; the boldface name of a syndrome is followed by a common alternative name when appropriate. Next, the Online Mendelian Inheritance in Man (OMIM™) index num- ber is listed. By accessing the OMIM™ website maintained by the National Center for Biotechnology Information at http://www.ncbi.nlm.nih.gov, the reader can supplement the material in the chapter with the latest research available on that syndrome. A MIM number without a prefix means that the mode of inheritance has not been proven. The prefix (*) in front of a MIM number means that the phenotype determined by the gene at a given locus is separate from those represented by other 526 chapter 10: ocular manifestations of inherited diseases 527 asterisked entries and that the mode of inheritance of the phe- notype has been proven. -
Minor Congenital Ocular Anomalies As Somatic Markers in Genetic Disorders
CASE STUDIES Ref: Ro J Pediatr. 2020;69(4) DOI: 10.37897/RJP.2020.4.9 MINOR CONGENITAL OCULAR ANOMALIES AS SOMATIC MARKERS IN GENETIC DISORDERS Iulia-Andrada Nemes-Dragan, Ana-Maria Dragan, Marius Bembea Faculty of Medicine and Pharmacy, University of Oradea, Romania ABSTRACT Introduction. Minor congenital ocular anomalies (MCOA) are important markers for the detection of certain genetic disorders. Even within the same disease, they can vary in their position, numbers or expression intensity. Early detection and diagnosis of genetic disorders are essential to find them and to interpret them correctly and quickly. Aim. The purpose of this study was to analyse MCOA in genetic diseases, to identify the main types of MCOA as well as to analyze associated genetic disorders. Material and methods. This is a prospective study of 118 cases presenting with genetic disorders that also pre- sented with MCOA. Its duration was from February 2015 to February 2019. Detailed ocular and adnexa examina- tions were performed. Results. Of 118 patients who were enrolled in this study, 84 (71%) had minor ocular anomalies with or without as- sociated major anomalies. Most common MCOA were identified in the eyelid, iris and retina. Down syndrome was the most frequent syndrome associated with MCOA. Conclusions. Minor congenital ocular abnormalities, even if they are not serious, are often suggestive of certain genetic syndromes. Regardless of the genetic disorders, anatomically, the eyelid is the ocular adnexa that always gives us minor clues of important diagnosis significance. Keywords: ocular anomalies, markers, genetic disorders INTRODUCTION tant to perform a detailed examination of these pa- tients, in order to identify other anomalies, as well as A minor congenital anomaly (MCA) represents to recognize possible specific associations in certain any somatic change, of any organ, which does not genetic syndromes. -
A Review of Hypertensive Retinopathy and Chorioretinopathy
Clinical Optometry Dovepress open access to scientific and medical research Open Access Full Text Article REVIEW A Review of Hypertensive Retinopathy and Chorioretinopathy This article was published in the following Dove Press journal: Clinical Optometry Mai Tsukikawa Abstract: Hypertensive retinopathy and choroidopathy have important short- and long-term Andrew W Stacey implications on patients’ overall health and mortality. Eye care professionals should be familiar with the severity staging of these entities and be able to readily recognize and Department of Ophthalmology, University of Washington, Seattle, WA refer patients who are in need of systemic blood pressure control. This paper will review the 98104, USA diagnosis, staging, treatment, and long-term implications for vision and mortality of patients with hypertensive retinopathy and choroidopathy. Keywords: hypertensive retinopathy, hypertensive choroidopathy, hypertensive chorioretinopathy Introduction Hypertension is a risk factor for many systemic conditions that cause serious morbidity and mortality. The World Health Organization defines hypertension as a systolic blood pressure of greater than 140 mmHg and/or a diastolic blood pressure of greater than 90 mmHg, with an estimated 1.13 billion people worldwide affected by this condition.1 Hypertension can affect the eyes in several ways, including the development of retinopathy, choroidopathy, and optic neuropathy. It is also a risk factor for other vision- threatening eye conditions including branch retinal artery occlusion (BRAO), central retinal artery occlusion (CRAO), branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO), retinal artery macroaneurysms, and non-arteritic anterior ischemic optic neuropathy (NAION). Hypertension increases the risk for the develop- ment and progression of diabetic retinopathy, glaucoma, and age-related macular degeneration.2 Hypertension is also a risk factor for the development of suprachoroidal hemorrhage during ophthalmic surgery.