Pseudotumor Cerebri and Papilledema an OVERVIEW of THIS PERPLEXING SYNDROME and ITS HALLMARK PRESENTATION
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BUSINESS, CONSUMER SERVICES, AND HOUSING AGENCY EDMUND G. BROWN JR., GOVERNOR STATE BOARD OF OPTOMETRY 2450 DEL PASO ROAD, SUITE 105, SACRAMENTO, CA 95834 0 P (916) 575-7170 F (916) 575-7292 www.optometry .ca.gov OPToMi fikY Continuing Education Course Approval Checklist Title: Provider Name: ☐Completed Application Open to all Optometrists? ☐ Yes ☐No Maintain Record Agreement? ☐ Yes ☐No ☐Correct Application Fee ☐Detailed Course Summary ☐Detailed Course Outline ☐PowerPoint and/or other Presentation Materials ☐Advertising (optional) ☐CV for EACH Course Instructor ☐License Verification for Each Course Instructor Disciplinary History? ☐Yes ☐No BUSINESS, CONSUMER SERVICES, AND HOUSING AGENCY GOVERNOR EDMUND G. BROWN JR. ~~ TATE BOARD OF OPTOMETRY }I /~E{:fLi\1 ~1' DELWSO ROAD, SUITE 105, SACRAMENTO, CA 95834 op'i,otii~l~ 1~0-A~ifiF' t\,rffi-7170 F (916) 575-7292 www.optometry.ca.gov EDUCATION COU Rw1t;--ftf""~'-!-J/-i~--,--__:___::...:..::....::~-~ $50 Mandatory Fee APPLICATION ,-~Jg l Pursuant to California Code of Regulations (CCR) § 1536, the Board will app~romv~e~c~ott=nfli1~nuFTT1t;tngn'zeWl:uc~rRif'tf-:~MT~~=ilt,;;,,_J receiving the applicable fee, the requested information below and it has been determined that the course meets criteria specified in CCR § 1536(g). In addition to the information requested below, please attach a copy of the course schedule, a detailed course outline and presentation materials (e.g., PowerPoint presentation). Applications must be submitted 45 days prior to the course presentation date. Please type or print -
Albinism Terminology
Albinism Terminology Oculocutaneous Albinism (OCA): Oculocutaneous (pronounced ock-you-low-kew- TAIN-ee-us) Albinism is an inherited genetic condition characterized by the lack of or diminished pigment in the hair, skin, and eyes. Implications of this condition include eye and skin sensitivities to light and visual impairment. Ocular Albinism (OA): Ocular Albinism is an inherited genetic condition, diagnosed predominantly in males, characterized by the lack of pigment in the eyes. Implications of this condition include eye sensitivities to light and visual impairment. Hermansky Pudlak Syndrome (HPS): Hermansky-Pudlak Syndrome is a type of albinism which includes a bleeding tendency and lung disease. HPS may also include inflammatory bowel disease or kidney disease. The severity of these problems varies much from person to person, and the condition can be difficult to diagnose with traditional blood tests Chediak Higashi Syndrome: Chediak Higashi Syndrome is a type of albinism in which the immune system is affected. Illnesses and infections are common from infancy and can be severe. Issues also arise with blood clotting and severe bleeding. Melanin: Melanin is pigment found in a group of cells called melanocytes in most organisms. In albinism, the production of melanin is impaired or completely lacking. Nystagmus: Nystagmus is an involuntary movement of the eyes in either a vertical, horizontal, pendular, or circular pattern caused by a problem with the visual pathway from the eye to the brain. As a result, both eyes are unable to hold steady on objects being viewed. Nystagmus may be accompanied by unusual head positions and head nodding in an attempt to compensate for the condition. -
Partial Albinism (Heterochromia Irides) in Black Angus Cattle
Partial Albinism (Heterochromia irides) in Black Angus Cattle C. A. Strasia, Ph.D.1 2 J. L. Johnson, D. V.M., Ph.D.3 D. Cole, D. V.M.4 H. W. Leipold, D.M.V., Ph.D.5 Introduction Various types of albinism have been reported in many Pathological changes in ocular anomalies of incomplete breeds of cattle throughout the world.4 We describe in this albino cattle showed iridal heterochromia grossly. paper a new coat and eye color defect (partial albinism, Histopathological findings of irides showed only the heterochromia irides) in purebred Black Angus cattle. In posterior layer fairly pigmented and usually no pigment in addition, the results of a breeding trial using a homozygous the stroma nor the anterior layer. The ciliary body showed affected bull on normal Hereford cows are reported. reduced amount of pigmentation and absence of corpora Albinism has been described in a number of breeds of nigra. Choroid lacked pigmentation. The Retina showed cattle.1,3-8,12,16,17 An albino herd from Holstein parentage disorganization. Fundus anomalies included colobomata of was described and no pigment was evident in the skin, eyes, varying sizes at the ventral aspect of the optic disc and the horns, and hooves; in addition, the cattle exhibited photo tapetum fibrosum was hypoplastic.12 In albino humans, the phobia. A heifer of black pied parentage exhibited a fundus is depigmented and the choroidal vessels stand out complete lack of pigment in the skin, iris and hair; however, strikingly. Nystagmus, head nodding and impaired vision at sexual maturity some pigment was present and referred to also may occur. -
Wavelength of Light and Photophobia in Inherited Retinal Dystrophy
www.nature.com/scientificreports OPEN Wavelength of light and photophobia in inherited retinal dystrophy Yuki Otsuka1, Akio Oishi1,2*, Manabu Miyata1, Maho Oishi1, Tomoko Hasegawa1, Shogo Numa1, Hanako Ohashi Ikeda1 & Akitaka Tsujikawa1 Inherited retinal dystrophy (IRD) patients often experience photophobia. However, its mechanism has not been elucidated. This study aimed to investigate the main wavelength of light causing photophobia in IRD and diference among patients with diferent phenotypes. Forty-seven retinitis pigmentosa (RP) and 22 cone-rod dystrophy (CRD) patients were prospectively recruited. We designed two tinted glasses: short wavelength fltering (SWF) glasses and middle wavelength fltering (MWF) glasses. We classifed photophobia into three types: (A) white out, (B) bright glare, and (C) ocular pain. Patients were asked to assign scores between one (not at all) and fve (totally applicable) for each symptom with and without glasses. In patients with RP, photophobia was better relieved with SWF glasses {“white out” (p < 0.01) and “ocular pain” (p = 0.013)}. In CRD patients, there was no signifcant diference in the improvement wearing two glasses (p = 0.247–1.0). All RP patients who preferred MWF glasses had Bull’s eye maculopathy. Meanwhile, only 15% of patients who preferred SWF glasses had the fnding (p < 0.001). Photophobia is primarily caused by short wavelength light in many patients with IRD. However, the wavelength responsible for photophobia vary depending on the disease and probably vary according to the pathological condition. Inherited retinal degenerations (IRDs) represent a diverse group of diseases characterized by progressive photo- receptor cell death that can lead to blindness 1. -
What Is Hermansky-Pudlak Syndrome?
American Thoracic Society PATIENT EDUCATION | INFORMATION SERIES What is Hermansky-Pudlak Syndrome? Hermansky-Pudlak Syndrome (HPS) is a rare inherited disease, named after two doctors in Czechoslovakia who, in 1959, recognized similar health conditions in two unrelated adults. Since the discovery of HPS, the condition has occurred all over the world but is most often seen in Puerto Rico. The most common health conditions with HPS are albinism, the tendency to Journal of Hematology bleed easily, and pulmonary fibrosis. A Figure 1. Normal platelet with dense bodies growing number of gene mutations have visualized by electron microscopy. been identified causing HPS (including numbers HPS1 to HPS10). What is albinism? Albinism is an inherited condition in which CLIP AND COPY AND CLIP reduced pigmentation (coloring) is present in the body. As a result, people with albinism are often fair-skinned with light hair. However, skin, hair, and eye color may vary, as some people with albinism may have dark brown hair and green or hazel/brown eyes. Journal of Hematology People with albinism all have low vision and Figure 2. Patient’s platelet with virtually absent dense bodies visualized by electron microscopy. varying degrees of nystagmus. All people who have HPS have albinism, but not all circulate in the blood stream and help the people with albinism have HPS. blood to clot. HPS patients have normal Skin problems—The reduction of numbers of platelets, but they are not pigmentation in the skin from albinism made correctly and do not function well, so results in an increased chance of developing the blood does not clot properly. -
National Eye Institute Visual Function Questionnaire (NEI- VFQ25) in Subjects with IIH and Normal Controls
Title: Correlation of Visual Function and National Eye Institute Visual Function Questionnaire (NEI- VFQ25) in subjects with IIH and normal controls. Melanie Truong, DO OD Introduction and Purpose Aims of the study: 1. To assess contrast sensitivity acuity and rapid eye movements (saccades) as a measure of visual function in Idiopathic Intracranial Hypertension (IIH) patients compared to normal patients using the King-Devick Variable Contrast Acuity Chart and the K-D rapid eye movement. 2. To assess subjects quality of visual function using the National Eye Institute Visual Function Questionnaire (NEI-VFQ25) questionnaire and Supplement as a comparison between IIH subjects and normal controls. 3. To study the correlation between visual function and quality of visual function questionnaire in subjects with IIH compared to normal controls. Contrast sensitivity is a measure of afferent visual system. Contrast sensitivity deficit with preservation of normal Snellen acuity has also been reported in glaucoma, compressive disorders of the anterior visual pathways, retinal diseases, and with cerebral lesions.1 This test is significantly more sensitive than Snellen acuity .1 It is also superior for serial testing in patients as there was significant improvement in contrast scores and papilledema grade but no significant change in Snellen acuity.1 Visual manifestation of IIH can also include parafoveal deficits. This can lead to deficits in spatial frequency contrast sensitivity.1 Contrast sensitivity is abnormal initially and improved with regression of papilledema.2 Since decisions on therapy in IIH are based on the presence and change in visual function, assessing visual acuities is not the most accurate measure of visual status in IIH. -
Central Serous Papillopathy by Optic Nerve Head Drusen
Clinical Ophthalmology Dovepress open access to scientific and medical research Open Access Full Text Article CASE REPORT Central serous papillopathy by optic nerve head drusen Ana Marina Suelves1 Abstract: We report a 38-year-old man with a complaint of blurred vision in his right eye for the Ester Francés-Muñoz1 previous 5 days. He had bilateral optic disc drusen. Fluorescein angiography revealed multiple Roberto Gallego-Pinazo1 hyperfluorescent foci within temporal optic discs and temporal inferior arcade in late phase. Diamar Pardo-Lopez1 Optical coherence tomography showed bilateral peripapillary serous detachment as well as right Jose Luis Mullor2 macular detachment. This is the first reported case of a concurrent peripapillary and macular Jose Fernando Arevalo3 detachment in a patient with central serous papillopathy by optic disc drusen. Central serous papillopathy is an atypical form of central serous chorioretinopathy that should be considered Manuel Díaz-Llopis1,4,5 as a potential cause of acute loss of vision in patients with optic nerve head drusen. 1 Department of Ophthalmology, La Fe Keywords: central serous papillopathy, peripapillary central serous chorioretinopathy, optic University Hospital, Valencia, Spain; For personal use only. 2Instituto de Investigación Sanitaria, nerve head drusen, peripapillary subretinal fluid Fundación para la investigación, La Fe Hospital, Valencia, Spain; 3Retina and vitreous service, Clínica Introduction Oftalmológica Centro Caracas, Optic nerve head drusen (ONHD) are hyaline material calcificated -
Common Eye Conditions
COMMON EYE CONDITIONS AMBLYOPIA Reduced acuity because of non-use of eye or extreme difference in acuities. Eye may be patched or surgery to correct. NYSTAGMUS - Cause unknown Involuntary rhythmic side-to-side, up-and-down, or circular (oscillating), eye movement that may be faster in one direction than the other (may be more marked in one eye than the other), reduced acuity due to inability to fixate. STRABISMUS - Defects of eye muscle Eyes are not aligned correctly, images may not fuse, brain may suppress one image resulting in permanent acuity reduction in eye where image is suppressed. ALBINISM – Hereditary – congenital (may involve all or part of body – non-progressive) Lack of pigment in eye, decreased acuity, nystagmus, strabismus, photophobia, visual fields variable, retina and macular involvement. ANIRIDIA – Hereditary Underdeveloped or absent iris. Decreased acuity, photophobia, nystagmus, cataracts, under developed retina. Visual fields normal unless glaucoma develops. CATARACTS – Congenital, hereditary, traumatic, disease, or age related (normal part of aging process) Lens opacity (chemical change in lens protein), decreased visual acuity, nystagmus, photophobia (light sensitivity). DIABETIC RETINOPATHY – Pathologic Retinal changes, proliferative – growth of abnormal new blood vessels, hemorrhage, fluctuating visual acuity, loss of color vision, field loss, retinal detachment, total blindness. GLAUCOMA (Congenital or adult) – “SNEAK THIEF OF SIGHT” hereditary, traumatic, surgery High intraocular pressure (above 20-21 mm of mercury) – (in children often accompanied by hazy corneas and large eyes), often due to obstructions that prevent fluid drainage, resulting in damage to optic nerve. Excessive tearing, photophobia, uncontrolled blinking, decreased acuity, constricted fields. HEMIANOPSIA – (Half-vision) optic pathway malfunction pathologic or trauma (brain injury, stroke or tumor) Macular vision may or may not be affected. -
Guidelines for Universal Eye Screening in Newborns Including RETINOPATHY of Prematurity
GUIDELINES FOR UNIVERSAL EYE SCREENING IN NEWBORNS INCLUDING RETINOPATHY OF PREMATURITY RASHTRIYA BAL SWASthYA KARYAKRAM Ministry of Health & Family Welfare Government of India June 2017 MESSAGE The Ministry of Health & Family Welfare, Government of India, under the National Health Mission launched the Rashtriya Bal Swasthya Karyakram (RBSK), an innovative and ambitious initiative, which envisages Child Health Screening and Early Intervention Services. The main focus of the RBSK program is to improve the quality of life of our children from the time of birth till 18 years through timely screening and early management of 4 ‘D’s namely Defects at birth, Development delays including disability, childhood Deficiencies and Diseases. To provide a healthy start to our newborns, RBSK screening begins at birth at delivery points through comprehensive screening of all newborns for various defects including eye and vision related problems. Some of these problems are present at birth like congenital cataract and some may present later like Retinopathy of prematurity which is found especially in preterm children and if missed, can lead to complete blindness. Early Newborn Eye examination is an integral part of RBSK comprehensive screening which would prevent childhood blindness and reduce visual and scholastic disabilities among children. Universal newborn eye screening at delivery points and at SNCUs provides a unique opportunity to identify and manage significant eye diseases in babies who would otherwise appear healthy to their parents. I wish that State and UTs would benefit from the ‘Guidelines for Universal Eye Screening in Newborns including Retinopathy of Prematurity’ and in supporting our future generation by providing them with disease free eyes and good quality vision to help them in their overall growth including scholastic achievement. -
Idiopathic Intracranial Hypertension
IDIOPATHIC INTRACRANIAL HYPERTENSION William L Hills, MD Neuro-ophthalmology Oregon Neurology Associates Affiliated Assistant Professor Ophthalmology and Neurology Casey Eye Institute, OHSU No disclosures CASE - 19 YO WOMAN WITH HEADACHES X 3 MONTHS Headaches frontal PMHx: obesity Worse lying down Meds: takes ibuprofen for headaches Wake from sleep Pulsatile tinnitus x 1 month. Vision blacks out transiently when she bends over or sits down EXAMINATION Vision: 20/20 R eye, 20/25 L eye. Neuro: PERRL, no APD, EOMI, VF full to confrontation. Dilated fundoscopic exam: 360 degree blurring of disc margins in both eyes, absent SVP. Formal visual field testing: Enlargement of the blind spot, generalized constriction both eyes. MRI brain: Lumbar puncture: Posterior flattening of Opening pressure 39 the globes cm H20 Empty sella Normal CSF studies otherwise normal Headache improved after LP IDIOPATHIC INTRACRANIAL HYPERTENSION SYNDROME: Increased intracranial pressure without ventriculomegaly or mass lesion Normal CSF composition NOMENCLATURE Idiopathic intracranial hypertension (IIH) Benign intracranial hypertension Pseudotumor cerebri Intracranial hypertension secondary to… DIAGNOSTIC CRITERIA Original criteria have been updated to reflect new imaging modalities: 1492 Friedman and Jacobsen. Neurology 2002; 59: Symptoms and signs reflect only those of - increased ICP or papilledema 1495 Documented increased ICP during LP in lateral decubitus position Normal CSF composition No evidence of mass, hydrocephalus, structural -
Amaurosis Fugax (Transient Monocular Or Binocular Vision Loss)
Amaurosis fugax (transient monocular or binocular vision loss) Syndee Givre, MD, PhD Gregory P Van Stavern, MD The next version of UpToDate (15.3) will be released in October 2007. INTRODUCTION AND DEFINITIONS — Amaurosis fugax (from the Greek "amaurosis," meaning dark, and the Latin "fugax," meaning fleeting) refers to a transient loss of vision in one or both eyes. Varied use of common terminology may cause some confusion when reading the literature. Some suggest that "amaurosis fugax" implies a vascular cause for the visual loss, but the term continues to be used when describing visual loss from any origin and involving one or both eyes. The term "transient monocular blindness" is also often used but is not ideal, since most patients do not experience complete loss of vision with the episode. "Transient monocular visual loss" (TMVL) and "transient binocular visual loss" (TBVL) are preferred to describe abrupt and temporary loss of vision in one or both eyes, since they carry no connotation regarding etiology. Transient visual loss, either monocular or binocular, reflects a heterogeneous group of disorders, some relatively benign and others with grave neurologic or ophthalmologic implications. The task of the clinician is to use the history and examination to localize the problem to a region in the visual pathways, identify potential etiologies, and, when indicated, perform a focused battery of laboratory tests to confirm or exclude certain causes. Therapeutic interventions and prognostic implications are specific to the underlying cause. This topic discusses transient visual loss. Other ocular and cerebral ischemic syndromes are discussed separately. APPROACH TO TRANSIENT VISUAL LOSS — By definition, patients with transient visual loss almost always present after the episode has resolved; hence, the neurologic and ophthalmologic examination is usually normal. -
Management of Nystagmus in Children: a Review of the Literature and Current Practice in UK Specialist Services
Eye https://doi.org/10.1038/s41433-019-0741-3 REVIEW ARTICLE Management of nystagmus in children: a review of the literature and current practice in UK specialist services 1,2 3 3 4 5 6 1,2 6 J. E. Self ● M. J. Dunn ● J. T. Erichsen ● I. Gottlob ● H. J. Griffiths ● C. Harris ● H. Lee ● J. Owen ● 7 1 8,9 10 J. Sanders ● F. Shawkat ● M. Theodorou ● J. P. Whittle ● Nystagmus UK Eye research group (NUKE) Received: 18 October 2019 / Accepted: 24 November 2019 © The Author(s) 2020. This article is published with open access Abstract Nystagmus is an eye movement disorder characterised by abnormal, involuntary rhythmic oscillations of one or both eyes, initiated by a slow phase. It is not uncommon in the UK and regularly seen in paediatric ophthalmology and adult general/ strabismus clinics. In some cases, it occurs in isolation, and in others, it occurs as part of a multisystem disorder, severe visual impairment or neurological disorder. Similarly, in some cases, visual acuity can be normal and in others can be severely degraded. Furthermore, the impact on vision goes well beyond static acuity alone, is rarely measured and may vary on a minute-to-minute, day-to-day or month-to-month basis. For these reasons, management of children with nystagmus in 1234567890();,: 1234567890();,: the UK is varied, and patients report hugely different experiences and investigations. In this review, we hope to shine a light on the current management of children with nystagmus across five specialist centres in the UK in order to present, for the first time, a consensus on investigation and clinical management.