DOCSLIB.ORG

Pupillary Responses in Amblyopia Br J Ophthalmol: First Published As 10.1136/Bjo.74.11.676 on 1 November 1990

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Pupillary Responses in Amblyopia Br J Ophthalmol: First Published As 10.1136/Bjo.74.11.676 on 1 November 1990 676 BritishlournalofOphthalmology, 1990,74,676-680 Pupillary responses in amblyopia Br J Ophthalmol: first published as 10.1136/bjo.74.11.676 on 1 November 1990. Downloaded from Alison Y Firth Abstract light was then alternatively switched from one Relative afferent pupillary defects (RAPD) eye to the other, giving a period of stimulation of were detected in 32*3% ofpatients with ambly- 1 to 2 seconds, and the initial pupillary con- opia by a modification ofthe swinging flashlight striction was observed. The light was then left in test and the synoptophore. After consideration front ofeach eye for a count of3 and the pupillary ofvarious clinical investigations the significant escape noted. factors identified in patients showing a RAPD If a pupillary defect was observed, a neutral were: anisometropia, early age of onset where density filter was placed in the arm of the strabismus was present, level of visual acuity synoptophore in front of the eye without the following treatment, longer period ofocclusion defect. In practice it was not found possible to therapy. These points bear similarities to the quantify the defect to within 0-1 log unit as has results of pattern electroretinograms (PERG) previously been reported,5 but merely to confirm in amblyopes, and the possibility of the its presence. Where no defect was initially causative defect being at ganglion cell level is apparent, a 0-3 log unit NDF was placed in discussed. The effect of occlusion treatment either arm in turn to produce a difference in cannot be predicted from the presence or response. In some cases this revealed a subtle absence of a RAPD. defect, as the pupillary response was still present but to a lesser extent in one eye while completely absent in the other. During the examination An afferent or relative afferent pupillary defect refractive correction was worn, the interpupillary has been reported to be present in between 9% distance corrected, and the tubes set at the and 93% of amblyopes.'' The main criticism of objective angle of deviation by rotating each arm these findings is that poor fixation in the ambly- equally, thus ensuring similar stimulation in opic eye may result in the light stimulus striking either eye. The patient fixed simultaneous different retinal areas.7 macular perception slides throughout. Routine orthoptic examination does not Where possible this test was performed blind, include a test capable of detecting small afferent but casual observation - as in cases of obvious or relative afferent pupillary defects. When anisometropia or strabismus, wearing of attempting to assess the latter, the swinging occlusion, comment on suppression - meant that flashlight test89 is used, but this has drawbacks the amblyopic eye was known to the examiner in for the examination of The child will some cases. children. http://bjo.bmj.com/ often look at the light causing constriction of the After the assessment of the pupillary reaction pupil due to the near reflex, which obscures the on the synoptophore the density of any response to light,'0 or the reaction may be suppression present was measured at the objec- blocked in excitable children." In addition other tive angle by dimming the rheostat in front ofthe disadvantages to the test include: confusion due non-suppressing eye until the 'suppressed' to hippus7 (one pupil being observed on the image could be seen and the rheostat number upswing and the other on the downswing), noted. The and were subjective objective angles on September 23, 2021 by guest. Protected copyright. presence of anisocoria,9 and the danger of using compared to elicit the type of retinal correspon- too bright a light, as an after image can keep the dence. pupils small and so prevent the pupillary Visual acuity was assessed (with the patient escape." 12 wearing refractive correction) by a linear test Pupillomotor changes have also been reported (Snellen or Snellen with key card). Some patients in suppression.'3 had their acuity tested with single optotypes The implication of the presence of a relative (Sheridan Gardiner), fixation by the Visuscope afferentpupillarydefectin diagnosis and manage- and contrast sensitivity by the American Optical mentofamblyopia has not beenfullydetermined. System (which is based on Arden's gratings). The purpose ofthis study was to discover factors The size ofpupilswasmeasured, as anyanisocoria common to amblyopes who display a defect with or more than 2 mm could make the testing of a view to ascertaining whether assessment of the pupillary responses inaccurate.9 pupillary response is of clinical value during the Further details were taken from the hospital treatment of amblyopia. records. These included: age at date of test, type of amblyopia, age at onset of strabismus, visual acuity prior to occlusion therapy (and test used), Methods and patients age at first occlusion, types of occlusion therapy Welsh School of Orthoptics, University To observe any asymmetry in pupillary response undergone, continuity of occlusion, best pre- Hospital of Wales, Heath the synoptophore was used with modification of vious visual acuity (if higher than on day of Park, Cardiff CF4 4XW the bright light source normally used for the testing), refractive correction, and fundus AY Firth production of after images. The light intensity examination. When any lesion of the fundus or Correspondence to: Alison Y Firth. was reduced by fitting neutral density filters media was present the patient was excluded. Accepted for publication (NDF) of 0-4 log units into the same rubber Since the study was of necessity conducted 7 June 1990 holder as each eye piece lens. The after image during normal clinical sessions, the selection of Pupillary responses in amblyopia 677 patients was haphazard. They were examined * RAPD Present Br J Ophthalmol: first published as 10.1136/bjo.74.11.676 on 1 November 1990. Downloaded from during their routine orthoptic examinations. o RAPD Absent Initially only patients with amblyopia were 601 (12) examined, but later all patients examined with no prior knowledge of whether or not amblyopia was present. No attempt was made to examine 50 patients under the age of 3 years. Nine children were followed up through occlusion therapy. A group of 25 children from a local junior ? 40 c0 school were used as controls. m9 z 30 Results Seventy six patients were examined with ages ranging from 3 years 2 months to 13 years 10 20 months. Sixty five had amblyopia, this being defined as any difference in linear visual acuity. The type ofamblyopia is shown in Table 1. 10 Of the patients with equal visual acuity four had previously had strabismic amblyopia which had responded to treatment, five had intermittent (0) or alternating deviations, and two had equal but Idiopathic Ansio Strab+Ansio Strab reduced visual acuity due to ametropic ambly- Type of Ambyopia opia. Figure 1 Relativefrequencies ofdifferent types of The pupillary responses in 72% of patients amblyopia: idiopathic, anisometropic (aniso), combination of strabismic and anisometropic (strab+aniso) and strabismic were examined blind. (strab) in patients with (shaded) and without (unshaded) a Of the 65 amblyopic patients 21 had a relative relative afferent pupilary defect (RAPD). Actual patient afferent pupillary defect in their amblyopic eye numbers shown in brackets. and two in their non-amblyopic eye. Of 25 controls tested a subtle defect was found in one of 26 without a defect were anisometropic, it was child. considered that this may have caused a bias. Contraction anisocoria is estimated to occur to Unfortunately the numbers were too small to an extent which is clinically visible in 5% of the analyse in the pure strabismic amblyopes, but in population." This may explain the finding of a a comparison of patients with anisometropia and defect in the control and non-amblyopic eyes. strabismus (Fig 2) the age at onset of the However, it could have been observer error. The strabismus was found by the Mann-Whitney U two patients with the defect in their non ambly- test to be significant at the p<005 level. opic eye were excluded from further consider- Various factors concerning occlusion were ation. considered: (a) age at first occlusion; (b) the http://bjo.bmj.com/ The type of amblyopia of the remaining 63 delay from onset of strabismus to start of patients was first considered (Fig 1). For statis- occlusion; (c) type and continuity (d) period of tical evaluation the idiopathic group was occlusion; and (e) time lapse from the last excluded because of the low number. By means occlusion to the date of testing. Of these, the of the likelihood ratio criterion the type of period ofocclusion (Fig 3) was the only significant amblyopia was shown to be significant at the p<0 02 level, and further grouping of patients Table 2 Presence or absence ofrelative afferent pupillary on September 23, 2021 by guest. Protected copyright. into those with or without anisometropia (Table defect (RAPD) in amblyopia involving anisometropia and 2) and those with or without strabismus (Table 3) amblyopia without anisometropia. Statistical evaluation showed only the difference in the former group given to be The amount significant (p<001). actual of Type ofamblyopia anisometropia, however, did not prove to be significant. Aniso and An accurate age at onset in those with strabis- Strab+Aniso Pure strab Total mus was given in 35 patients. The Mann- RAPD present 17 4 21 Whitney U test showed the age at onset to be at a RAPD absent 18 22 40 significantly younger age in those with a relative Total 35 26 61 afferent pupillary defect (p=0 0294). However, df= as eight out of the nine patients with a pupillary XL'=7-7297883, 1, p<OOl (2 tailed). defect also had anisometropia and only seven out Table 3 Presence or absence ofrelative afferent pupillary defect (RAPD) in amblyopia involving strabismus and amblyopia without strabismus.
Load more

Recommended publications
  • URGENT/EMERGENT When to Refer Financial Disclosure
    URGENT/EMERGENT When to Refer Financial Disclosure Speaker, Amy Eston, M.D. has a financial interest/agreement or affiliation with Lansing Ophthalmology, where she is employed as a ophthalmologist. 58 yr old WF with 6 month history of decreased vision left eye. Ache behind the left eye for 2-3 months. Using husband’s contact lens solution made it feel better. Seen by two eye care professionals. Given glasses & told eye exam was normal. No past ocular history Medical history of depression Takes only aspirin and vitamins 20/20 OD 20/30 OS Eye Pressure 15 OD 16 OS – normal Dilated fundus exam & slit lamp were normal Pupillary exam was normal Extraocular movements were full Confrontation visual fields were full No red desaturation Color vision was slightly decreased but the same in both eyes Amsler grid testing was normal OCT disc – OD normal OS slight decreased RNFL OCT of the macula was normal Most common diagnoses: Dry Eye Optic Neuritis Treatment - copious amount of artificial tears. Return to recheck refraction Visual field testing Visual Field testing - Small defect in the right eye Large nasal defect in the left eye Visual Field - Right Hemianopsia. MRI which showed a subacute parietal and occipital lobe infarct. ANISOCORIA Size of the Pupil Constrictor muscles innervated by the Parasympathetic system & Dilating muscles innervated by the Sympathetic system The Sympathetic System Begins in the hypothalamus, travels through the brainstem. Then through the upper chest, up through the neck and to the eye. The Sympathetic System innervates Mueller’s muscle which helps to elevate the upper eyelid.
    [Show full text]
  • Real Time Measurement and Processing of Pupillary Light Reflex for Early Detection of Disease
    Journal of Computers Real Time Measurement and Processing of Pupillary Light Reflex for Early Detection of Disease Ippei Torii*, Takahito Niwa Aichi Institute of Technology, Dept. of Information Science, 1247 Yachigusa, Yakusa-cho, Toyota, Aichi, Japan. * Corresponding author. Tel.: 81-565-48-8121; email: mac[aitech.ac.jp Manuscript submitted January 10, 2019; accepted March 8, 2019. doi: 10.17706/jcp.14.3.161-169 Abstract: Recently, pupillary measurements have begun to be considered effective in the diagnosis of various physical conditions. Apart from optic neuropathy and retinal disorders, which are ocular diseases, diversions can be expected in the diagnosis of autonomic disturbance due to sympathetic and parasympathetic nerve disorders, cranial nerve disorders, cerebral infarction, depression, and diabetes. In this study, we have developed a real-time pupil diameter measuring system that is inexpensive and does not require a complicated device. When strong light is projected onto the eyeball, this system can measure the reaction time until the start of miosis, the time to achieve maximal miosis, and the difference in reaction speed of the left and right eyes. With this system, the status of a disease can be judged based on the distance from the threshold value. Key words: Real time measurement, eye movement, early detection of disease, image processing. 1. Introduction There are approximately one hundred million photoreceptor cells in the retina of human eyes. Light that shines on those cells is converted to nerve signals, which transmit the information to the brain, resulting in the visual recognition of objects. When light is radiated onto the eye, the pupillary light reflex is triggered, causing the pupillary diameter to decrease with a time delay of less than 1 sec.
    [Show full text]
  • The Pupillary Light Reflex in the Critically Ill Patient
    light must be high for the iris to be seen, which reduces Editorials the step increase induced by the penlight).6 If the pupillary light reflex amplitude is less than 0.3 mm and the maximum constriction velocity is less than 1 mm/s, the reflex is unable to be detected using a The pupillary light reflex in penlight.6 In conscious patients with Holmes-Adie and Argyll-Robertson pupils with ‘absent’ pupillary light the critically ill patient reflexes, small light reflexes have been detected using infrared pupillometry.7 Also in post-resuscitation non- brain dead critically ill patients with ‘absent’ pupillary The pupillary response to light is controlled by the reflexes, the reflex has been demonstrated using a autonomic nervous system. The direct pupillary light portable infrared pupillometer.6 reflex refers to miosis that occurs in the stimulated eye; In this issue of Critical Care and Resuscitation, the consensual pupillary light reflex refers to miosis that Thomas8 describes a case of Guillain Barré syndrome occurs in the other eye. The reflex has a latent period presenting with weakness and fixed dilated pupils who with length of the period, amplitude of the response, and subsequently became ‘locked in’ with absence of any the speed of the pupillary constriction dependent on the clinical response to external stimuli. A positive brain intensity of the stimulus employed.1 For the reflex to be stem auditory evoked response was used to indicate truly tested, an intense stimulus and close observation normal brain stem function. In another recent report, a are required. The reflex has afferent, efferent and central case of ‘reversible fixed dilated pupils’ was associated connections; therefore non-response to light (i.e.
    [Show full text]
  • What's the Connection?
    WHAT’S THE CONNECTION? Sharon Winter Lake Washington High School Directions for Teachers 12033 NE 80th Street Kirkland, WA 98033 SYNOPSIS Students elicit and observe reflex responses and distinguish between types STUDENT PRIOR KNOWL- of reflexes. They then design and conduct experiments to learn more about EDGE reflexes and their control by the nervous system. Before participating in this LEVEL activity students should be able to: Exploration, Concept/Term Introduction Phases ■ Describe the parts of a Application Phase neuron and explain their functions. ■ Distinguish between sensory and motor neurons. Getting Ready ■ Describe briefly the See sidebars for additional information regarding preparation of this lab. organization of the nervous system. Directions for Setting Up the Lab General: INTEGRATION Into the Biology Curriculum ■ Make an “X” on the chalkboard for the teacher-led introduction. ■ Health ■ Photocopy the Directions for Students pages. ■ Biology I, II ■ Human Anatomy and Teacher Background Physiology A reflex is an involuntary neural response to a specific sensory stimulus ■ AP Biology that threatens the survival or homeostatic state of an organism. Reflexes Across the Curriculum exist in the most primitive of species, usually with a protective function for ■ Mathematics animals when they encounter external and internal stimuli. A primitive ■ Physics ■ example of this protective reflex is the gill withdrawal reflex of the sea slug Psychology Aplysia. In humans and other vertebrates, protective reflexes have been OBJECTIVES maintained and expanded in number. Examples are the gag reflex that At the end of this activity, occurs when objects touch the sides students will be able to: or the back of the throat, and the carotid sinus reflex that restores blood ■ Identify common reflexes pressure to normal when baroreceptors detect an increase in blood pressure.
    [Show full text]
  • A Model of Accommodative-Pupillary Dynamics Stanley Gordon Day Iowa State University
    Iowa State University Capstones, Theses and Retrospective Theses and Dissertations Dissertations 1969 A model of accommodative-pupillary dynamics Stanley Gordon Day Iowa State University Follow this and additional works at: https://lib.dr.iastate.edu/rtd Part of the Electrical and Electronics Commons Recommended Citation Day, Stanley Gordon, "A model of accommodative-pupillary dynamics " (1969). Retrospective Theses and Dissertations. 4649. https://lib.dr.iastate.edu/rtd/4649 This Dissertation is brought to you for free and open access by the Iowa State University Capstones, Theses and Dissertations at Iowa State University Digital Repository. It has been accepted for inclusion in Retrospective Theses and Dissertations by an authorized administrator of Iowa State University Digital Repository. For more information, please contact [email protected]. This dissertation has been microâhned exactly as received 69-15,607 DAY, Stanley Gordon, 1939- A MODEL OF ACCOMMODATIVE-PUPILLARY DYNAMICS. Iowa State University, Ph.D., 1969 Engineering, electrical University Microfilms, Inc., Ann Arbor, Michigan ®Copyright by STANLEY GORDON DAY 1969 A MODEL OF ACCOMMODATIVE-PUPILLARY DYNAMICS by Stanley Gordon Day A Dissertation Submitted to the Graduate Faculty in Partial Fulfillment of The Requirements for the Degree of DOCTOR OF PHILOSOPHY Major Subject : Electrical Engineering Approved: Signature was redacted for privacy. In Charge of Major Work Signature was redacted for privacy. Head of Major Department Signature was redacted for privacy. Dea^ of Gradulate College Iowa State University Of Science and Technology Ames, Iowa 1969 il TABLE OF CONTENTS Page DEDICATION iii INTRODUCTION 1 REVIEW OF LITERATURE 4 EQUIPMENT AND METHODS 22 RESULTS AND DISCUSSION 47 SUÎ4MARY AND CONCLUSIONS 60 BIBLIOGRAPHY 62 ACKNOWLEDGEMENTS 68 APPENDIX 69 i iii DEDICATION This dissertation is dedicated to Sandra R.
    [Show full text]
  • The Pupillary Light Reflex in Normal Subjects
    Br J Ophthalmol: first published as 10.1136/bjo.65.11.754 on 1 November 1981. Downloaded from British Journal ofOphthalmology, 1981, 65, 754-759 The pupillary light reflex in normal subjects C. J. K. ELLIS From St Thomas's Hospital, London SE] SUMMARY In 19 normal subjects the pupillary reflex to light was studied over a range of stimulus intensities by infrared electronic pupillography and analysed by a computer technique. Increasing stimulus intensity was associated with an increase in direct light reflex amplitude and maximum rate of constriction and redilatation. Latency from stimulus to onset of response decreased with increas- ing stimulus intensity. The normal range for each of these parameters is given and the significance of these results in clinical pupillary assessment discussed. The technique of infrared pupillometry' has allowed PUPILLOMETRY the normal pupillary response to light to be studied in A Whittaker Series 1800 binocular infrared television detail. Lowenstein and Friedman2 have shown that pupillometer was used in this study. All recordings in response to light the pupil constricts after a latent were made in darkness with no correction for refrac- period and that the length of this latent period, the tive error. The eyes were illuminated from a low- copyright. amplitude of the response, and the speed of the intensity, invisible infrared source and observed by pupillary constriction are dependent on the stimulus means of a closed circuit television system sensitive to intensity employed. These findings have subse- infrared light. The pupils were displayed on television quently been confirmed.3" monitor screens providing instantaneous feedback of Borgmann6 gave 95% confidence limits in defining the quality of the pupil images.
    [Show full text]
  • Melanopsin and Cone Photoreceptor Inputs to the Afferent Pupil Light Response
    ORIGINAL RESEARCH published: 22 May 2019 doi: 10.3389/fneur.2019.00529 Melanopsin and Cone Photoreceptor Inputs to the Afferent Pupil Light Response Andrew J. Zele 1,2*, Prakash Adhikari 1,2, Dingcai Cao 3 and Beatrix Feigl 1,4,5 1 Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT), Brisbane, QLD, Australia, 2 School of Optometry and Vision Science, Queensland University of Technology (QUT), Brisbane, QLD, Australia, 3 Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, United States, 4 School of Biomedical Sciences, Queensland University of Technology (QUT), Brisbane, QLD, Australia, 5 Queensland Eye Institute, Brisbane, QLD, Australia Background: Retinal photoreceptors provide the main stage in the mammalian eye for regulating the retinal illumination through changes in pupil diameter, with a small population of melanopsin-expressing intrinsically photosensitive retinal ganglion cells (ipRGCs) forming the primary afferent pathway for this response. The purpose of this Edited by: study is to determine how melanopsin interacts with the three cone photoreceptor Victoria Susan Pelak, University of Colorado Denver, classes in the human eye to modulate the light-adapted pupil response. United States Methods: We investigated the independent and combined contributions of the inner Reviewed by: and outer retinal photoreceptor inputs to the afferent pupil pathway in participants with Jason Charng, Lions Eye Institute, Australia trichromatic color vision using a method to independently control the excitations of Chiara La Morgia, ipRGCs, cones and rods in the retina. IRCCS Istituto delle Scienze Neurologiche di Bologna (ISNB), Italy Results: We show that melanopsin-directed stimuli cause a transient pupil constriction *Correspondence: generated by cones in the shadow of retinal blood vessels; desensitizing these penumbral Andrew J.
    [Show full text]
  • Advanced Anatomy & Physiology of The
    By Diane F. Drake, LDO, ABOM, NCLEM, FNAO Introduction Terminology Presbyopia Anatomy Muscle Imbalances Refractive Errors Unequal refractive errors Spherical Correction Visualizing the Rx Cylindrical Correction Visual Angle and Minimum Visual Angle Minimum Visual Angle Visual Angle Subtend To extend under or to be opposite to The angle which is opposite the object being observed Minimum Detail The detail that must be detected on an object to positively identify or distinguish the object Minimum Detail E Minimum Detail Resolution The ability to detect minimum detail The resolving power of the normal eye is a minimum visual angle of 1 minute E The minimum visual angle of the letter is 1 minute The visual angle of the letter is 5 minutes Visual Acuity The measure of the angle subtended by the outer limits of rays of light coming from the minimum detail of an object as they enter the eye 20/20 or 6/6 Snell’s Law of Refraction n1 sin i = n2 sin r The Snellen Fraction The distance at which the test is made divided by the distance at which the smallest letter read subtends an angle of 5 minutes Snellen Letters Snellen Letters Minimum Angle of Resolution Landolt Ring (C) and the Illiterate E Contrast Sensitivity Terminology Emmetropia Ametropia Myopia Hyperopia Terminology Astigmatism Simple myopic Corneal astigmatism astigmatism Lenticular astigmatism Compound myopic Regular astigmatism astigmatism Irregular astigmatism Simple hyperopic astigmatism Compound hyperopic astigmatism Terminology Presbyopia Greek Presby
    [Show full text]
  • Retinal Sensitivity Measured by the Pupillary Light Reflex in Rcs and Albino Rats
    VisionRus. Vol. 22. pp. II63 to 1171, 1982 0042-6989/82/091 l63-09$03.00/O Printedin Great Britain Pergamon Press Ltd RETINAL SENSITIVITY MEASURED BY THE PUPILLARY LIGHT REFLEX IN RCS AND ALBINO RATS LEONARD J. TREJO* and CAROL M. CICERONE Department of Psychology, C-009, University of California, San Diego, La Jolla, CA 92093, U.S.A. (Receiwd 14 July 1981; in reuised,fbrm 17 February 1982) Abstract-The effects of retinal degeneration on the sensitivity of the retina were studied in the Royal College of Surgeons (RCS) rat by measuring the light reflex of the pupil in response to ganzfeld (full field) flashes. Light reflex thresholds were measured for animals from 32 to 683 days of age, and an age-related decrease in sensitivity of 5.2 log units (maximum) was measured. In contrast, thresholds for non-dystrophic albino controls increased only slightly during a comparable period. RCS rat thresholds increased more for short wavelength light than for long wavelength light. The end result was an altered action spectrum of the light reflex which largely, but not exclusively, reflected cone function. Even in cases of advanced degeneration the light reflex thresholds we measured showed significant input from rods. Pupillary dark adaptation measured following ganzfeld bleaches (10%) with test stimuli of two different wavelengths revealed two mechanisms; a photopic mechanism (&,.,, = 520) determined thresholds early in dark adaptation, but later a scotopic mechanism (;.,,,,,, = 500) participated in the light reflex INTRODUCTION (dark adapted) conditions. Although the exclusive presence of units with photopic sensitivity in the RCS The Royal College of Surgeons (RCS) rat suffers from hereditary retinal degeneration (Dowling and Sidman, retina provides evidence for the selective survival of cones, it is conceivable that many scotopic units 1962) and has served as an animal model of the class of inherited human diseases, retinitis pigmentosa remain undetected.
    [Show full text]
  • 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.
    [Show full text]
  • Intermittent Mydriasis Associated with Carotid Vascular Occlusion
    Eye (2018) 32, 457–459 © 2018 Macmillan Publishers Limited, part of Springer Nature. All rights reserved 0950-222X/18 www.nature.com/eye 1,2 2 2 Intermittent mydriasis PD Chamberlain , A Sadaka , S Berry CASE SERIES 1,2,3,4,5,6 associated with carotid and AG Lee vascular occlusion Abstract the literature as benign episodic pupillary dilation or BEUM. We report two patients with Purpose To describe two cases of 1 stereotyped, intermittent, neurologically acquired occlusive disease of the ipsilateral ICA Department of Ophthalmology, Blanton isolated, unilateral mydriasis in patients who developed multiple, stereotyped, neurologically isolated, transient episodes of Eye Institute, Houston with a history of acquired internal carotid Methodist Hospital, artery (ICA) occlusive disease on the mydriasis consistent with BEUM. We discuss the Houston, TX, USA ipsilateral side. possible mechanisms, differential diagnosis and 2 Patients Two patients with intermittent recommended evaluation for atypical cases for Department of episodic mydriasis. Ophthalmology, Baylor mydriasis. College of Medicine, Methods Case Series. Houston, TX, USA Results Case one: A 78-year-old man Case one 3 experienced 10 episodes of intermittent, Departments of Ophthalmology, Neurology, unilateral, and painless mydriasis in the left A 78-year-old man presented with 10 episodes of and Neurosurgery, Weill stereotyped, intermittent, unilateral, painless eye and had 100% occlusion of the left ICA Cornell Medical College, artery due to atherosclerotic disease. Case two: pupillary dilation of the left eye (OS) lasting New York, NY, USA A 26-year-old woman with history of migraine minutes to hours at a time without diplopia or fi 4Department of developed new painless, intermittent episodes ptosis.
    [Show full text]
  • Anatomy & Physiology of The
    Anatomy & Physiology of The Eye 2017-2018 Done By: 433 Team Abdullah M. Khattab Important Doctor’s Notes Extra Abdullah AlOmair Resources: Team 433, Doctors Notes, Vaughan & Asbury’s General ophthalmology. Editing File Embryology of The Eye ............................................................................................. 2 ● Defects: ........................................................................................................................... 2 Development of The Eye After Birth .......................................................................... 3 ● Refractive power depends on two factors: ...................................................................... 3 The Orbit ................................................................................................................... 4 ● Seven bones contribute the bony orbit and surrounded by nasal sinuses. .................... 4 ● The orbital wall, pear-like shaped, formed by: ................................................................ 4 ● Structures Passing Through the Optic Openings: ........................................................... 4 Extraocular Muscles .................................................................................................. 1 ● Anatomy .......................................................................................................................... 1 ● Notes: .............................................................................................................................. 1 ● Field of action:
    [Show full text]