OC.UM.CP.0063 Visual Field Testing
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Ocular Injury; Hazard to Society: a Case Series
Quest Journals Journal of Medical and Dental Science Research Volume 7~ Issue 8 (2020) pp: 34-44 ISSN(Online) : 2394-076X ISSN (Print):2394-0751 www.questjournals.org Research Paper Ocular Injury; Hazard to Society: A Case Series Dr Rashmi kujur1, Dr Pallavi. M.P2, Dr Harshita Dubey3, Dr Varsha4 1Dept. of ophthalmology, Madhav dispensary JAH, GRMC, Gwalior, Madhyapradesh. 2Senior girls hostel, GRMC, Gwalior, Madhyapradesh. 3Senior girls hostel, GRMC, Gwalior, Madhyapradesh. 4Senior girls hostel, GRMC, Gwalior,Madhyapradesh. Corresponding Author: Dr.Pallavi.M.P ABSTRACT Purpose: To describe various types of ocular trauma due to different modes of injuryoccured on the same day Design: Prospective interventional study (case series) Materials & Methods: A series of cases of ocular trauma in different age group on the same day. Results: Five patients of ocular trauma were studied & managed. All five patients were males. Out of 5 cases, 3 cases had open globe injury and 2 cases had closed globe injury. Three out of five patients required surgical intervention while 2 patients were managed with medical therapy. Conclusion: This study describes the types and characteristics of ocular trauma presenting in eye department. The frequency of ocular trauma is common in males. Eye injuries resulting from ocular trauma pose a frequent threat to vision the world over. While afocussed history and prompt ocular examination are essential to immediate management, patient educationregarding safety precautions and risk reduction help to prevent future recurrences. KEYWORDS: Ocular morbidity, Ocular Injury, globe rupture, iridodialysis, fire cracker injury, hyphema, Road Traffic accident (RTA), loss of vision. Received 05 December, 2020; Accepted 20 December, 2020 © The author(s) 2020. -
Visual Field Test
EYE FACTS visual field test Your visual field refers to how much you can see around you, including objects in your peripheral (side) vision. This test produces a map of your field of vision. Visual field tests help your ophthalmologist (Eye M.D.) monitor any loss of vision and diagnose eye problems and disease. Visual field testing is used to monitor peripheral, or side, vision. HOW IS A VISUAL FIELD TEST PERFORMED? The test is performed with a large, bowl-shaped in- Normal visual field Severe visual loss strument called a perimeter. In order to test one eye at a time, one of your eyes is temporarily patched during the test. You will be seated and positioned comfortably in front of the perimeter and asked to look straight ahead at a fixed spot (the fixation target). The computer randomly flashes points of light around the bowl-shaped perimeter. When you see a light, press the indicator button. It is very important These grids are results of visual field tests.T he dark to always keep looking straight ahead. Do not move black shaded areas show where loss of vision has your eyes to look for the target; wait until it appears occurred. in your side vision. It is normal for some of the lights to be difficult to see. A delay in seeing a light does not necessarily mean your field of vision is damaged. If you need to rest during the test, tell the technician and they will pause the test until you are ready to continue. Your ophthalmologist will interpret the results of your test and discuss them with you. -
Optic Disc and Macular Vessel Density Measured by Optical
www.nature.com/scientificreports OPEN Optic Disc and Macular Vessel Density Measured by Optical Coherence Tomography Angiography in Open-Angle and Angle-Closure Glaucoma Tzu-Yu Hou1,2, Tung-Mei Kuang1,2, Yu-Chieh Ko1,2, Yu-Fan Chang1,2, Catherine Jui-Ling Liu1,2 & Mei-Ju Chen1,2* There is distinct pathogenesis between primary open-angle glaucoma (POAG) and primary angle- closure glaucoma (PACG). Although elevated intraocular pressure (IOP) is the major risk factor for glaucoma, non-IOP risk factors such as vascular abnormalities and lower systolic/diastolic perfusion pressure may play a role in the pathogenic process. This study aimed to compare the vessel density (VD) in the optic disc and macula using optical coherence tomography angiography (OCTA) between POAG and PACG eyes. Thirty-two POAG eyes, 30 PACG eyes, and 39 control eyes were included. All the optic disc VD parameters except the inside disc VD were signifcantly lower in glaucomatous eyes than in control eyes. Compared with PACG eyes, only the inferior temporal peripapillary VD was signifcantly lower in POAG eyes. The parafoveal VD was signifcantly lower in each quadrant in glaucomatous eyes than in control eyes. The central macular and parafoveal VD did not difer between POAG and PACG eyes. In conclusion, the inferior temporal peripapillary VD was signifcantly reduced in POAG eyes compared with PACG eyes, while PACG eyes showed a more evenly distributed reduction in the peripapillary VD. The distinct patterns of VD change may be associated with the diferent pathogenesis between POAG and PACG. Glaucoma is an optic neuropathy characterised by progressive loss of retinal ganglion cells and their axons accompanied by corresponding visual feld (VF) defects. -
Physical Eye Examination
Physical Eye Examination Kaevalin Lekhanont, MD Department of Ophthalmology Ramathibodi Hospp,ital, Mahidol Universit y Outline • Visual acuity (VA) testing – Distant VA test – Pinhole test – Near VA test • Visual field testing • Record and interpretations Outline • Penlight examination •Swingggping penli ght test • Direct ophthalmoscopy – Red reflex examination • Schiotz tonometry • RdditttiRecord and interpretations Conjunctiva, Sclera Retina Cornea Iris Retinal blood vessels Fovea Pupil AtAnteri or c ham ber Vitreous Aqueous humor Lens Optic nerve Trabecular meshwork Ciliary body Choriod and RPE Function evaluation • Visual function – Visual acuity test – Visual field test – Refraction • Motility function Anatomical evaluation Visual acuity test • Distant VA test • Near VA test Distance VA test Snellen’s chart • 20 ฟุตหรือ 6 เมตร • วัดที่ละขาง ตาขวากอนตาซาย • ออานทละตาานทีละตา แถวบนลงลแถวบนลงลางาง • บันทึกแถวลางสุดที่อานได Pinhole test VA with pinhole (PH) Refractive error emmetitropia myypopia hyperopia VA record 20/200 ผูปวยสามารถอานต ัวเลขทมี่ ี ขนาดใหญขนาดใหญพอทคนปกตพอที่คนปกติ สามารถอานไดจากท ี่ระยะ 200 ฟตฟุต แตแตผผปูปวยอานไดจากวยอานไดจาก ที่ระยะ 20 ฟุต 20/20 Distance VA test • ถาอานแถวบนสุดไไไมได ใหเดินเขาใกล chthart ทีละกาวจนอานได (10/200, 5/200) • Counting finger 2ft - 1ft - 1/2ft • Hand motion • Light projection • Light perception • No light perception (NLP) ETDRS Chart Most accurate Illiterate E chart For children age ≥ 3.5 year Near VA test Near chart •14 นวิ้ หรอื 33 เซนตเมตริ • วัดที่ละขาง ตาขวากอนตาซาย • อานทีละตา แถวบนลงลาง -
Documentation Dissection
Documentation Dissection Pre and Postoperative diagnosis: Uncontrolled moderate open angle glaucoma, left eye |1|. Procedure: Trabeculectomy of externo with peripheral iridectomy |2| Anesthesia: Conscious sedation, peribulbar block. Estimated blood loss: Less than 1 cc. COMPLICATIONS: None. The patient has had progressive visual field deterioration on maximum tolerated medications, and pressures in the high teens with a diagnosis of uncontrolled open angle glaucoma, left eye. To preserve her visual field, it was felt that surgery was necessarygiven the extensive damage to her optic nerve and field already existing |3|. The risks, benefits, and alternatives to surgery were discussed with the patient as well as with her husband, and she was anxious to proceed. PROCEDURE: The patient was brought to the operating room where she was given an intravenous sedative and peribulbar block. She was then prepped and draped in customary sterile fashion for intraocular surgery. A wire lid speculum was placed, and a 6-0 Vicryl traction suture was put through the superior peripheral cornea. The globe was retracted downward. The conjunctiva was entered 12 mm proximal to the limbus. With a combination of blunt and sharp dissection it was dissected down to the surgical limbus. The Gill’s knife was used to bare the limbus, and hemostasis was achieved with bipolar cautery |4|. A 4 x 4 mm rectangular lamellar flap was outlined with the 200 to 300 micron blade, |5| after which Mitomycin C 0.3 mg/cc was applied to the surface of the sclera overlying the outlying trap door for 2 minutes 30 seconds. The sponge and all instruments used to manipulate the Micomycin sponge were removed from the field, and the eye was vigorously irrigated with balanced salt solution (BSS). -
An Investigation of Visual Field Test Parameters in Glaucoma, Patterns Of
An investigation of visual field test parameters in glaucoma, patterns of visual field loss in diabetics and multispectral imaging of the optic nerve head in glaucoma A thesis submitted to The University of Manchester for the degree of Doctor of Philosophy in the Faculty of Medical and Human Sciences 2012 Yanfang Wang School of Medicine (Human Development) 1 CONTENTS Title page……………………………………………………………1 Contents……………………………………………………….........2 List of Tables………………………………………………………..9 List of Figures……………………………………………………..10 List of Abbreviations……………………………………………...14 Abstract …………………………………………………………...16 Declaration………………………………………………………...17 Copyright statement………………………………………………17 Acknowledgment……………………………………………...…..19 1. Rationale of the study…………………………………………..20 2. Glaucoma……………………………………………………….24 2.1- Classification of glaucoma……………………………………….........24 2.2 - Clinical assessment in glaucoma……………………………………..27 2.2.1- IOP measurement………………………………………………..27 2.2.2 - Examination of structural and functional loss in glaucoma….28 2.3 - Management…………………………………………………………..32 3. Visual field testing……………………………………………..33 3.1 - Stimuli and background……………………………………………...33 3.2 - Test strategies………………………………………………………….34 3.2.1 - Frequency-of-seeing (FOS) curve and threshold………………34 3.2.2 - Supra-threshold strategy………………………………………..36 2 3.2.3 - Threshold strategy……………………………………………….38 3.2.3.1 - Full threshold, Fastpac and SITA………………………….38 3.2.3.2 - 30-2, 24-2 and 10-2 stimulus distributions…………………41 3.3 - Interpretation of results……………………………………………...42 3.3.1 -
Traumatic Retinal Detachment Br J Ophthalmol: First Published As 10.1136/Bjo.75.1.18 on 1 January 1991
18 BritishJournalofOphthalmology, 1991,75, 18-21 Traumatic retinal detachment Br J Ophthalmol: first published as 10.1136/bjo.75.1.18 on 1 January 1991. Downloaded from P B Johnston Abstract trauma is a well recognised cause of rhegmato- Seventy-seven patients developed retinal genous retinal detachment, which was reported breaks following an episode of ocular con- by Eagling' to affect 4-6% of such injuries. The tusion, and 65 (84.4%) of these developed characteristics of postcontusion retinal detach- rhegmatogenous retinal detachment. Surgical ments were described by Cox et all and the treatment successfully restored or maintained mechanism ofbreak formation was elucidated by retinal apposition in 74 (96-1%) of the eyes. Delori et all who studied the effect of high speed Thirty-six (46-8%) eyes recovered visual acuity projectiles on enucleated pig eyes. Experimental of6/9orbetter. Ofthe retinal breaks recognised evidence indicates that retinal breaks form at the dialysis at the ora serrata was observed in 49 time of ocular impact. However, clinical reports eyes, of which 28 were situated at the lower show considerable delay in the diagnosis of temporal quadrant. Seventeen eyes had post-traumatic retinal detachment. For example, irregular breaks arising within necrotic retina Cox et all reported that only 30% of post- at the site of scleral impact. Twenty-four traumatic retinal detachments were diagnosed (31.2%) patients had retinal break or retinal within one month of injury, and Ross4 found detachment diagnosed within 24 hours ofinjury 40% in a similar period. and 49 (63-6%) within six weeks. Immediate The following study is of a series of patients retinal detachment was a feature of necrotic who developed retinal breaks or retinal detach- retinal breaks, while inferior oral dialyses led ment after ocular contusion. -
Bass – Glaucomatous-Type Field Loss Not Due to Glaucoma
Glaucoma on the Brain! Glaucomatous-Type Yes, we see lots of glaucoma Field Loss Not Due to Not every field that looks like glaucoma is due to glaucoma! Glaucoma If you misdiagnose glaucoma, you could miss other sight-threatening and life-threatening Sherry J. Bass, OD, FAAO disorders SUNY College of Optometry New York, NY Types of Glaucomatous Visual Field Defects Paracentral Defects Nasal Step Defects Arcuate and Bjerrum Defects Altitudinal Defects Peripheral Field Constriction to Tunnel Fields 1 Visual Field Defects in Very Early Glaucoma Paracentral loss Early superior/inferior temporal RNFL and rim loss: short axons Arcuate defects above or below the papillomacular bundle Arcuate field loss in the nasal field close to fixation Superotemporal notch Visual Field Defects in Early Glaucoma Nasal step More widespread RNFL loss and rim loss in the inferior or superior temporal rim tissue : longer axons Loss stops abruptly at the horizontal raphae “Step” pattern 2 Visual Field Defects in Moderate Glaucoma Arcuate scotoma- Bjerrum scotoma Focal notches in the inferior and/or superior rim tissue that reach the edge of the disc Denser field defects Follow an arcuate pattern connected to the blind spot 3 Visual Field Defects in Advanced Glaucoma End-Stage Glaucoma Dense Altitudinal Loss Progressive loss of superior or inferior rim tissue Non-Glaucomatous Etiology of End-Stage Glaucoma Paracentral Field Loss Peripheral constriction Hereditary macular Loss of temporal rim tissue diseases Temporal “islands” Stargardt’s macular due -
CACI - Glaucoma Worksheet (Updated 04/26/2017)
CACI - Glaucoma Worksheet (Updated 04/26/2017) The Examiner must review a current status report by the treating physician and any supporting documents to determine the applicant’s eligibility for certification. If the applicant meets ALL the acceptable certification criteria listed below, the Examiner can issue. Applicants for first- or second- class must provide this information annually; applicants for third-class must provide the information with each required exam. AME MUST REVIEW ACCEPTABLE CERTIFICATION CRITERIA Treating ophthalmologist finds the [ ] Yes condition stable on current regimen and no changes recommended. Age at diagnosis [ ] 40 or older FAA Form 8500-14 or equivalent [ ] Yes treating physician report that documents the considerations below: Acceptable types of glaucoma [ ] Open Angle being monitored and stable, Ocular Hypertension or Glaucoma Suspect being monitored and stable, or previous history of Narrow Angle/Angle Closure Glaucoma which has been treated with iridectomy /iridotomy (surgical or laser) and is currently stable. NOT acceptable: Normal Tension Glaucoma, secondary glaucoma due to inflammation, trauma, or the presence of any other significant eye pathology (e.g. neovascular glaucoma due to proliferative diabetic retinopathy or an ischemic central vein occlusion or uveitic glaucoma) Documented nerve damage or [ ] No trabeculectomy (filtration surgery) Medications [ ] None or Prostaglandin analogs (Xalatan, Lumigan, Travatan or Travatan Z), Carbonic anhydrase inhibitor (Trusopt and Azopt), Beta blockers (Timoptic, etc), or Alpha agonist (Alphagan). Combination eye drops are acceptable NOT acceptable for CACI: Pilocarpine or other miotics, cycloplegics (Atropine), or oral medications. Medication side effects [ ] None Intraocular pressure [ ] 23 mm Hg or less in both eyes ANY evidence of defect or reported [ ] No Unreliable Visual Fields Acceptable visual field tests: Humphrey 24-2 or 30-2 (either SITA or full threshold), Octopus (either TOP or full threshold). -
Medicare Quarterly Provider Compliance Newsletter Guidance to Address Billing Errors
DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services Medicare Quarterly Provider Compliance Newsletter Guidance to Address Billing Errors Updated Provider Index Now Available! See the Introduction section for more details Volume 3, Issue 4 - July 2013 ICN 908787/ July 2013 Table of Contents Comprehensive Error Rate Testing (CERT): Home Health Certification......................................................................... 1 CERT Finding: Glucose Monitoring Supplies .......................................... 3 CERT Finding: Inpatient Psychiatric Facility Prospective Payment System (PPS) ............................................................................ 5 Recovery Auditor Finding: Infusion Pump Denied/Accessories & Drug Codes Should Be Denied ............................................................. 7 Recovery Auditor Finding: Overutilization of Nebulizer Medications .... 8 Recovery Auditor Finding: Post-Acute Transfer - Underpayments ..... 10 Recovery Auditor Finding: Co-Surgery Not Billed with Modifier 62 .... 11 Recovery Auditor Finding: Pre-admission Diagnostic Testing Review ....................................................................................... 13 Recovery Auditor Finding: Duplicate Claims ...................................... 15 Recovery Auditor Finding: Add-on HCPCS/CPT Codes Without Primary Codes........................................................................... 17 Recovery Auditor Finding: Dose versus Units Billed - Bevacizumab (HCPCS J9035) and Rituximab -
Visual Field & Otc Tests Care Instructions
DR. CAROLYN ANDERSON EYE SURGERY CARE INSTRUCTIONS VISUAL FIELD & OTC TESTS To ensure the health of your Visual Field Test eye(s), please read this information sheet carefully. Your visual field is the entire area that you can see when the eye is forward, including your peripheral vision. As most of us use two eyes, the overlapping fields allow you to see in an arc of 180 degrees. Certain diseases can cause a loss of visual field, and unless If you need to cancel your the defect is extensive, you will not be aware of it. appointment, please let us know as soon as possible at The Humphrey Field Analyzer 2 uses a computer-controlled, projected beam of light to 604.530.6838. map the visual field, which is then compared by a computer against a database of normal readings. The Visual Field test results are plotted on paper, extending about 90 degrees If you have any questions or to the temple side, and 60 degrees to the nose side. Dr. Anderson will examine the Visual concerns, please speak with Field results, and from the type and location of the defect (if any) can tell where in Dr. Anderson. the visual system the problem may lie. The field test is also used to monitor possible progression of diseases like glaucoma and can indicate if more intensive therapy (if any) is needed. The test is done by a technician and takes approximately 30 minutes. Drops are not generally used, so your vision should not be affected. Appointment date: Time: Optical Coherence Tomographer (OCT) Test The Optical Coherence Tomographer is a type of scanning laser ophthalmoscope, which uses a low-powered laser and a computer to build up a three-dimensional picture of the optic nerve, macula, and other structures in the back of the eye. -
Vertical Perspective Medical Assistance Program
Kansas Vertical Perspective Medical Assistance Program December 2006 Provider Bulletin Number 688 General Providers Emergent and Nonemergent Diagnosis Code List Attached is a list of diagnosis codes and whether the Kansas Medical Assistance Program (KMAP) considers the code to be emergent or nonemergent. Providers are responsible for validating whether a particular diagnosis code is covered by KMAP under the beneficiary’s benefit plan and that all program requirements are met. This list does not imply or guarantee payment for listed diagnosis codes. Information about the Kansas Medical Assistance Program as well as provider manuals and other publications are on the KMAP Web site at https://www.kmap-state-ks.us. If you have any questions, please contact the KMAP Customer Service Center at 1-800-933-6593 (in-state providers) or (785) 274-5990 between 7:30 a.m. and 5:30 p.m., Monday through Friday. EDS is the fiscal agent and administrator of the Kansas Medical Assistance Program for the Kansas Health Policy Authority. Page 1 of 347 Emergency Indicators as noted by KMAP: N – Never considered emergent S – Sometimes considered emergent (through supporting medical documentation) Y – Always considered emergent Diagnosis Emergency Diagnosis Code Description Code Indicator 0010 Cholera due to Vibrio Cholerae S 0011 Cholera due to Vibrio Cholerae El Tor S 0019 Unspecified Cholera S 019 Late Effects of Tuberculosis N 0020 Typhoid Fever S 0021 Paratyphoid Fever A S 0022 Paratyphoid Fever B S 0023 Paratyphoid Fever C S 024 Glanders Y 025 Melioidosis