DOCSLIB.ORG

A Rare Presentation of Cyclitis Induced Myopia Umar Ijaz, Asad Habib and Hassan Sajjad Rathore

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
A Rare Presentation of Cyclitis Induced Myopia Umar Ijaz, Asad Habib and Hassan Sajjad Rathore CASE REPORT A Rare Presentation of Cyclitis Induced Myopia Umar Ijaz, Asad Habib and Hassan Sajjad Rathore ABSTRACT Unilateral cyclitis leading to myopia is a rare and clinical relevant entity. In clinical settings, pseudomyopia is generally encountered in the form of accommodative spasm, which is always bilateral. Cyclitis due to inflammation, on the other hand, can cause pseudomyopia unilaterally and it is a very rare presentation. A young male with acute anterior uveitis, presented with acute episode of unilateral myopia. When patient was examined on first visit, there were no cells in anterior chamber; so he was started on cycloplegic eye drops, but his condition didn't improve. Examination on subsequent visit revealed cellular reaction in anterior chamber and narrowing of anterior chamber angles on anterior segment optical coherence tomography (OCT). Treatment for uveitis was started and patient's visual acuity and refractive error improved. Pseudomyopia is a known complication of several drugs and certain medical conditions. The possible mechanism is supraciliary exudation causing relaxation of zonular fibers and increased convexity of the crystalline lens. Myopia in the setting of a mild cellular reaction can easily be missed and has not been reported yet to the best of authors’ literature search. Key Words: Myopia. Uveitis. Iridocyclitis. INTRODUCTION started on cyclopentolate eye drops and then atropine Myopia or near-sightedness means that light rays coming eye drops, but no improvement in visual acuity was from a distance are unable to focus on retina, but they observed. Next visit revealed a visual acuity of 6/75 right eye improving to 6/9 with refraction of -4.00 DS along focus short of retina causing a blurred vision. Either it with cells in anterior chamber (AC) in right eye and can be due to enlarged eye ball (axial myopia) or due to pharmacologically dilated pupils bilaterally. Posterior increase dioptric power of lens itself (lenticular). Some segment examination was normal. Intraocular pressure medical conditions and drugs are also known to cause a (IOP) measured by Goldman applanation tonometer myopic shift. Commonly reported medical conditions are was 12 and 18 mmHg in right and left eye, respectively. hyperglycemia, scleritis, choroidal inflammation, Vogt- Both these new findings, i.e. difference in IOP and cells Koyonagi-Harada disease, and juvenile idiopathic in AC, pointed towards cyclitis. To confirm, anterior arthritis.1 Certain drugs which are reported to cause a chamber optical coherence tomography (OCT) was myopic shift include corticosteroids, sulfa drugs, done to measure the anterior chamber angle, which acetazolamides and topiramate.2-6 came out to be 17.5 degrees in right eye as compared to The relationship between uveitis and pseudomyopia is 58.9 degrees in the left eye (Figure 2). Patient was of clinical significance; and can easily be missed. It is started on steroid eye drops 3 hourly and systemic rarely reported in the literature,7 and is, therefore, worth steroids 1 mg/ kg body weight in divided doses. publishing. Patient was asked for follow-up after three days. Cells in CASE REPORT AC disappeared, redness and conjunctival congestion A 35-year man reported with complaints of decreased disappeared, and visual acuity improved to 6/9 with a vision from his right eye for the last few days associated refractive error of +0.50 DS on AR. Patient was advised with mild redness and pain. On examination, he had visual acuity of 6/36 improving to 6/6 with refraction of - 3.00 diopter sphere (DS), while that in left eye was 6/6. Autorefractometer (AR) also reported a refractive error of -3.25 DS (Figure 1). Color vision and near visual acuity was normal in both eyes. Both anterior and posterior segment of both eyes were normal. Keeping in mind the possible diagnosis of ciliary spasm, patient was Department of Ophthalomogy, Armed Forces Institute of Ophthalmology, Rawalpindi. Correspondence: Dr. Asad Habib, Armed Forces Institute of Ophthalmology, Mall Road, Military Hospital, Rawalpindi. E-mail: [email protected] Received: May 26, 2017; Accepted: December 03, 2017. Figure 1: Autorefractometer showing refractive error before and after treatment. S56 Journal of the College of Physicians and Surgeons Pakistan 2018, Vol. 28 (Special Supplement 1 of Case Reports): S56-S57 Cyclitis induced myopia to continue topical medication and review after two In our opinion, the cycloplegics (cyclopentolate, atropine) weeks for repeat anterior chamber OCT, which revealed did not relieve his myopia, initially because there was a an open angle of 49.3 degrees in the right eye (Figure 2). persistent edema of the ciliary body which was further Vision improved to 6/6 and anterior chamber was quiet. relaxing the zonular fibers, making the lens more Patient was discharged after follow-up and advised to globular. As soon as the patient was started on steroids, come back for consultation, if symptoms reappear. the ciliary edema subsided, the ciliary muscles assumed their normal position, and the pseudomyopia was relieved. In conclusion, acute unilateral iridocyclitis can present as pseudomyopia. To the best of our knowledge, this was the first case in our setting which presented as pseudomyopia in a backdrop of acute iridocyclitis, and Figure 2: Anterior segment OCT showing angle measurements before treatment. such a rare presentation of this disease has never been reported before. In contrast to treatment by cycloplegics only, this disease entity responds well to the routine acute anterior uveitis treatment. REFERENCES 1. Herbort CP, Papadia M, Neri P. Myopia and inflammation. J Ophthalmic Vis Res. 2011; 6:270-83. Figure 3: Anterior segment OCT showing angle measurements after treatment. 2. Panday VA, Rhee DJ. Review of sulfonamide-induced acute myopia and acute bilateral angle-closure glaucoma. Compr DISCUSSION Ophthalmol Update 2006; 8:271-6. Pseudomyopia may be defined as the sporadic and 3. Bhattacharyya KB, Basu S. Acute myopia induced by temporary shift of the refractive power of the eye topiramate: report of a case and review of the literature. Neurol towards myopia. It may occur alone as a sporadic entity India 2005; 53:108. or it may manifest as the spasm of synkinetic reflex, i.e. 4. Brandão MN, Fernandes IC, Barradas FF, Machado JF, with pupil constriction and convergent strabismus. The Oliveira MT. Acute myopia and angle closure glaucoma aetiology of this condition varies from organic, traumatic, associated with topiramate use in a young patient: case report. iatrogenic causes to functional and drug-related causes.8,9 Arq Bras Oftalmol 2009; 72:103-5. Pseudomyopia has also been documented in inflammatory 5. Rapoport Y, Benegas N, Kuchtey RW, Joos KM. Acute myopia conditions like sclero-choroidal inflammation and multifocal and angle closure glaucoma from topiramate in a seven-year- choroiditis, though its manifestation in iridocyclitis has old: a case report and review of the literature. BMC Pediatr never been documented.10 2014; 14:96. When this patient presented to the outpatient department 6. Boonyaleephan S. Bilateral acute onset myopia and angle for the first time with blurred vision in right eye, he was closure glaucoma after oral topiramate: a case report. J Med suspected as a case of simple accommodative spasm Assoc Thai 2008; 91:1904. due to increase in refractive power of the eye and 7. Mantovani A, Resta A, Herbort CP, El Asrar AA, Kawaguchi T, absence of any organic pathology, after going through Mochizuki M, et al. Work-up, diagnosis and management of an extensive history and examination protocol. acute Vogt-Koyanagi-Harada disease. Int Ophthalmol 2007; Therefore, he was prescribed cycloplegic eye drops 27:105-15. initially and was called for follow-up. On subsequent 8. Stratos AA, Peponis VG, Portaliou DM, Stroubini TE, Skouriotis S, visits, the myopic shift kept on increasing and initial Kymionis GD. Secondary pseudomyopia induced by signs of acute anterior uveitis started to appear. Further amisulpride. Optom Vis Sci 2011; 88:1380-2. investigations and imaging results were consistent with 9. Chan RP, Trobe JD. Spasm of accommodation associated with narrow angle, possibly secondary to cyclitis. The patient closed head trauma. J Neuro-ophthalmol 2002; 22:15-7. was then started on topical and oral steroids, to which he 10. Herbort CP, Papadia M, Neri P. Myopia and inflammation. responded effectively and his vision returned to normal. J Ophthalmic Vis Res. 2011; 6:270-83. Journal of the College of Physicians and Surgeons Pakistan 2018, Vol. 28 (Special Supplement 1 of Case Reports): S56-S57 S57.
Load more

Recommended publications
  • Ophthalmic Drugs Part 2 — the Pros and Cons of Cycloplegia
    CET Continuing education Ophthalmic drugs Part 2 — The pros and cons of cycloplegia n active ciliary body In the second of our series looking at drugs and their use in controls the eye’s accommodation process, optometric practice, Catherine Viner discusses cycloplegics, how allowing near focusing they work, when they should be used and how to undertake to occur. The ciliary body is made up mainly cycloplegic refraction. Module C19478, one general CET point for Aof smooth muscle, known as the ciliary optometrists and dispensing opticians muscle. Accommodation occurs when the muscarinic receptors within the ciliary muscle are stimulated by the parasympathetic neurotransmitter, acetylcholine (see Part 1 Optician Poor acuity and/or stereopsis 29.06.12). The ciliary muscle then In paediatric patients, these can be contracts, pulling the ciliary body indicative of amblyopia, potentially forward. Tension in the suspensory caused by uncorrected hypermetropia, ligaments supporting the crystalline lens astigmatism, anisometropia or is reduced. As a result, the lens becomes strabismus. To fully investigate the more convex, and thereby increases its cause, a cycloplegic refraction is refractive power. Adequate focus for recommended. nearer targets is then achieved.1 To obtain the true distance correction, Family history of squint, it is imperative that refraction takes amblyopia or hypermetropia place when the patient has relaxed A child is predisposed to these his/her accommodation. For most conditions if a positive family history adults and some children, this can be exists. Should this be the case, due to the achieved by directing the patient to potential risk of amblyopia, it would view a non-accommodative distance seem sensible to fully investigate the target.
    [Show full text]
  • How Effective Are Atropine Eye Drops at Reducing Myopia Progression in Children?
    The University of Manchester Research How effective are atropine eye drops at reducing myopia progression in children? Document Version Final published version Link to publication record in Manchester Research Explorer Citation for published version (APA): Jinabhai, A., & Glover, M. (2019). How effective are atropine eye drops at reducing myopia progression in children? Optometry in Practice (OiP), 20(3), 1-18. [EV-59579 C-72220]. https://www.college-optometrists.org/oip- resource/atropine-eye-drops-to-control-myopia-progression.html Published in: Optometry in Practice (OiP) Citing this paper Please note that where the full-text provided on Manchester Research Explorer is the Author Accepted Manuscript or Proof version this may differ from the final Published version. If citing, it is advised that you check and use the publisher's definitive version. General rights Copyright and moral rights for the publications made accessible in the Research Explorer are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights. Takedown policy If you believe that this document breaches copyright please refer to the University of Manchester’s Takedown Procedures [http://man.ac.uk/04Y6Bo] or contact [email protected] providing relevant details, so we can investigate your claim. Download date:03. Oct. 2021 Optometry in Practice (Online) ISSN 2517-5696 Volume 20 Issue 3 How effective are atropine eye drops at reducing myopia progression in children? Amit Navin Jinabhai PhD BSc(Hons) MCOptom FBCLA FHEA FEAOO and Mark Glover BSc(Hons) MCOptom The University of Manchester, Faculty of Biology Medicine and Health, School of Health Sciences, Division of Pharmacy and Optometry EV-59579 C-72220 1 CET point for UK optometrists Abstract Myopia is a global problem which typically shows the highest prevalence in the Far East.
    [Show full text]
  • Myopia and Accommodative Insufficiency Associated with Moderate Head Trauma Steve Leslie, B Optom, FACBO, FCOVD Private Practice
    Article Myopia and Accommodative Insufficiency Associated with Moderate Head Trauma Steve Leslie, B Optom, FACBO, FCOVD Private Practice ABSTRACT test the hypothesis that TBI can cause a loss of spatial Background: Brain injury as a result of moderate control of accommodation, with accommodation head trauma may result in the development of tending to localize at the individual’s dark focus. myopia and significant accommodative dysfunction Keywords: accommodation, acquired myopia, for individuals who previously had no history of dark focus, head trauma, moderate brain injury myopia prior to the head trauma. This combination of visual changes has not been studied to any Introduction significant degree. Moderate traumatic brain injury is defined as Methods: The records of fifteen patients with a having an initial Glasgow Coma Scale score between history of moderate traumatic brain injury (TBI) that 9-12, with loss of consciousness lasting minutes to resulted in myopia and accommodative insufficiency, hours, and long lasting or permanent physical and but with no prior history of myopia nor strabismus, cognitive impairments.1,2 Traumatic brain injury were reviewed retrospectively. Information regarding (TBI), especially of a moderate to severe degree, age, sex, distance refraction and near vision function commonly results in significant ocular and visual was assessed. problems.3,4,5 Results: The majority of subjects reviewed had Almost all studies concerning the visual effects developed a stable degree of myopia between 1.00 of TBI report a high incidence of “blurred vision”, and 2.00 diopters, as well as an abnormally high lag although frequently the reports do not differentiate of accommodation.
    [Show full text]
  • Accommodation and Vergence Testing Procedures
    ACCOMMODATION AND VERGENCE TESTING PROCEDURES Lab Manual for: V652 CLINICAL SCIENCES III: Accommodation and Binocular Vision (This material is not for unauthorized duplication or distribution) INDIANA UNIVERSITY SCHOOL OF OPTOMETRY FALL 2015 Instructor: David A. Goss, O.D., Ph.D. Email: [email protected] www.opt.indiana.edu/people/faculty/goss.htm 1 2 CONTENTS OF V652 LABORATORY MANUAL LAB SCHEDULE: …………………………………………………..page 5 PAGE REFERENCES IN REFERENCE TEXTS:.…………..…...page 7 LAB # 1: Binocular Vision Tests at Distance ……………………...page 9 LAB #2: Binocular Vision Tests & Relative Accommodation Tests at Near………………….……… page 25 LAB #3: Binocular Vision Tests at Near; Sequencing & Tentative Add …………………………………………page 43 LAB #4: MEM Dynamic Retinoscopy & Accommodative Facility……………………………………………………page 57 LAB #5: Dynamic Retinoscopy & Alternative Phoria and Vergence Tests…...………………………………….………...page 69 LAB #6: Additional Binocular Vision Tests …………….…..……page 83 LAB #7: Cycloplegic Refraction; Tests for Presbyopia ……….page 103 PROFICIENCY #1: Prelims, refraction & photometry ……....page 116 PROFICIENCY #2: Near-point tests, alternative tests, & dynamic retinoscopy ……………………page 125 3 INTRODUCTION In the first part of the course you will continue to learn more of the procedures in a basic vision examination with emphasis on binocular vision evaluation. Then you will learn more of the auxiliary or alternative tests that you will need for Clinic and you will learn the conditions under which it will be advisable to use them. This manual is designed to be the laboratory instructions for the course. At the end of the instructions for each lab you will find two copies of the laboratory report for that lab. One of these report forms needs to be turned in at the end of each lab period to the teaching assistant for the lab.
    [Show full text]
  • Pseudomyopia with Paradoxical Accommodation: a Case Report in Ki Park1, Young Kee Park2, Jae-Ho Shin3 and Yeoun Sook Chun4*
    Park et al. BMC Ophthalmology (2021) 21:159 https://doi.org/10.1186/s12886-021-01907-5 CASE REPORT Open Access Pseudomyopia with paradoxical accommodation: a case report In Ki Park1, Young Kee Park2, Jae-Ho Shin3 and Yeoun Sook Chun4* Abstract Background: Pseudomyopia is caused by increased refractive power by ciliary muscle spasm. Most patients cannot overcome pseudomyopia spontaneously; therefore, treatment of pseudomyopia is fastidious and needs a multidisciplinary approach. We report a case of unusual pseudomyopia with paradoxical accommodation, straining eyes to induce emmetropia at far distance and relaxing eyes to focus at near objects, contrary to physiological accommodation. Case presentation: A 33-year-old woman experienced intermittent distant vision discomfort. This occurred at least a few hundred times daily. She could see near objects clearly; however, distant objects could be seen clearly only when she strained her eyes. Uncorrected distance visual acuity was 20/20 and manifest refraction (MR) in both eyes in the relaxed state was approximately − 2.5 D. MR changed to approximately − 0.5 D when she grimaced and strained her eyes when attempting to focus on distant letters. Her response was contrary to the physiological accommodative response. Cycloplegic refraction was approximately 0.0 D. Binocular autorefractor/ keratometer was used to objectively evaluate her refractive response and pupil reaction according to accommodative stimulation. The IOL Master was used to evaluate the anterior chamber depth (ACD), lens thickness (LT), and pupil diameter with relaxed and strained eyes. For stepwise static accommodative stimuli (1–5D),therefractiveresponses were correspondingly stepwise, similar to those elicited by healthy individuals.
    [Show full text]
  • Clues for the Diagnosis of Accommodative Excess and Its Treatment with a Vision Therapy Protocol
    Ophthalmology Research: An International Journal 13(3): 32-42, 2020; Article no.OR.60891 ISSN: 2321-7227 Clues for the Diagnosis of Accommodative Excess and Its Treatment with a Vision Therapy Protocol Carmelo Baños1,2, Eneko Zabalo3 and Irene Sánchez1,4,5* 1Departamento de Física Teórica, Atómica y Óptica, Universidad de Valladolid, Valladolid, Spain. 2General Optica, Burgos, Spain. 3Bidasoa Optika, Ikusgune Centro de optometría, Donostia-San Sebastián, Spain. 4Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain. 5Optometry Research Group, IOBA Eye Institute, School of Optometry, University of Valladolid, 47011, Valladolid, Spain. Authors’ contributions This work was carried out in collaboration among all authors. Author CB designed the study, performed the statistical analysis, wrote the protocol, wrote the first draft of the manuscript and managed the literature searches. Author EZ collected the data, wrote the protocol, managed the literature searches and wrote the first draft of the manuscript. Author IS designed the study, performed the statistical analysis, wrote the protocol, managed the analyses of the study, managed the literature searches and wrote the first draft of the manuscript. All authors read and approved the final manuscript. Article Information DOI: 10.9734/OR/2020/v13i330171 Editor(s): (1) Dr. Tatsuya Mimura, Tokyo Women's Medical University Medical Center East, Japan. Reviewers: (1) Md. Abdul Alim, Rural Development Academy (RDA), Bangladesh. (2) Carlo Artemi,
    [Show full text]
  • Accommodative Spasm: Case Series
    [Downloaded free from http://www.tnoajosr.com on Sunday, June 16, 2019, IP: 10.232.74.23] Case Series Accommodative Spasm: Case Series Anjali Kavthekar, N. Shruti, M. Nivean, M. Nishanth Paediatric Ophthalmology Services, M.N. Eye Hospital Private Limited, Chennai, Tamil Nadu, India Abstract This study highlights importance of cycloplegic refraction to detect accommodative spasm(AS) patients and role of atropinisation for its management.This retrospective case series study was done at a tertiary care eye hospital in Chennai, India. Four patients, presented with complaints of sudden onset blurring of vision and asthenopic symptoms with history of aggravation of symptoms with prolonged near work and under stressful conditions.Refraction was initially showing myopic refractive error.After cycloplegia,there was hypermetropic shift and VA was 20/20 for distance in all patients with their hyperopic correction,and N6 with upto +3.00 dioptres for near.Diagnosis of AS was made. Bifocal glasses were prescribed and atropinisation(1%) with avoidance of aggravating factors was started . Patients were tapered gradually to prevent recurrence over three months and were observed for six months in which none had reccurence.Post cycloplegia,the condition resolved and asthenopic symptoms were improved. Keywords: Accommodative spasm, atropinization, cycloplegia, pseudomyopia INTRODUCTION started on bifocal or plus glasses along with atropine (1%) or homatropine (2%) eye drops on weekly twice basis and were Accommodative spasm (AS) is an asthenopic condition due evaluated two weekly. Eye drops were tapered every month to prolonged contraction of ciliary muscles.[1] Cycloplegic gradually over 3 months and patients were observed up to refraction is the key modality to unmask AS presenting as 6 months [Figure 1].
    [Show full text]
  • Cas Case Study
    zz Available online at http://www.journalcra.com INTERNATIONAL JOURNAL OF CURRENT RESEARCH International Journal of Current Research Vol. 9, Issue, 10, pp.58834-58836, October, 2017 ISSN: 0975-833X CASE STUDY ACCOMODATIVE SPASM- VARIED PRESENTATION AND TREATMENT *,1Dr. Vidhya, C., 2Dr. Khushbugupta and 3Uma Ballav 1 Consultant,2 Pediatric Ophthalmology Dept., Sankara Eye Hospital, Bangalore, India Fellow,3 Pediatric Ophthalmology Dept., Sankara Eye Hospital, Bangalore, India B.Sc (optom), Optometrist, Sankara Eye Hospital, Bangalore, India ARTICLE INFO ABSTRACT Article History: Aim: The aim of our study was to analyse the varied presentation and difficulties encountered while Received 22nd July, 2017 treating the patients with accomodative spasm. Received in revised form Methods: A retrospective study of four patients of accomodative spasm. Three were children and one 07th August, 2017 adult. All underwent a thorough work-up to be diagnosed with accommodation spasm and then Accepted 27th September, 2017 treated with vision therapy. Published online 17th October, 2017 Results: Average age of the patients was 14.25 years. All the patients underwent in-office vision therapy for the average of 16 sessions followed by maintenance therapy. The average follow-up Key words: period was 9 months (range – 6-9 months). One patient didn’t showed improvement after 12 sessions Accomodative spasm, as expected, so sent for systemic evaluation. She was diagnosed with hypothyroidism and treated for AACE, pseudomyopia, the same and continued with vision therapy. One patient presented with acute acquired comitant Vision therapy. esotropia (AACE) with pseudomyopia. With the treatment of accomodative spasm, the esotropia and the pseudomyopia resolved. Conclusion: We have discussed about the varied presentation of accomodative spasm and the promising results with vision therapy.
    [Show full text]
  • Pilocarpine Nitrate (Pilocarpine Nitrate) Eye Drops
    AUSTRALIAN PRODUCT INFORMATION – MINIMS® PILOCARPINE NITRATE (PILOCARPINE NITRATE) EYE DROPS 1 NAME OF THE MEDICINE Pilocarpine Nitrate 2 QUALITATIVE AND QUANTITATIVE COMPOSITION Minims Pilocarpine Nitrate Eye Drops contains pilocarpine nitrate 2% (20 mg/mL). No preservatives are included in the formulation. For the full list of excipients, see section 6.1 List of excipients. 3 PHARMACEUTICAL FORM A single-use eye drops, solution. Minims Pilocarpine Nitrate Eye Drops are single-use, clear, colourless sterile ophthalmic solutions. No preservatives are included in the formulation. 4 CLINICAL PARTICULARS 4.1 THERAPEUTIC INDICATIONS Chronic glaucoma and a miotic for reversing the effects of the weaker mydriatics and in emergency treatment of glaucoma. 4.2 DOSE AND METHOD OF ADMINISTRATION For topical ophthalmic use only. Not for injection into the eye Miotics are normally administered at the end of an ophthalmological examination while mydriatics are given at the beginning. Systemic absorption may be reduced by compressing the lacrimal sac at the medial canthus for a minute during and following instillation of drops. It is especially advisable when administering pilocarpine to children. Adults (including the elderly) and children Miosis: To induce miosis 1 or 2 drops should be used. Glaucoma: In cases of emergency treatment of acute narrow angle glaucoma, 1 drop should be used every 5 minutes until miosis is achieved. Each Minims unit should be discharged after a single use. Minims Pilocarpine PI-A20190104 v4 Page 1 of 9 4.3 CONTRAINDICATIONS Miotics are contraindicated in conditions where pupillary constriction is undesirable such as acute iritis, pupillary block glaucoma, acute uveitis, anterior uveitis, iridocyclitis, acute iritis and some forms of secondary glaucoma.
    [Show full text]
  • Care of the Patient with Myopia : Clinical Practice Guideline
    OPTOMETRY: OPTOMETRIC CLINICAL THE PRIMARY EYE CARE PROFESSION PRACTICE GUIDELINE Doctors of optometry are independent primary health care providers who examine, diagnose, treat, and manage diseases and disorders of the visual system, the eye, and associated structures as well as diagnose related systemic conditions. Optometrists provide more than two-thirds of the primary eye care services in the United States. They are more widely distributed geographically than other eye care providers and are readily accessible for the delivery of eye and vision care services. There are approximately 32,000 full-time equivalent doctors of optometry currently in practice in the United States. Optometrists practice in more than 7,000 communities across the United States, serving as the sole primary eye care provider in Care of the Patient with more than 4,300 communities. The mission of the profession of optometry is to fulfill the vision and eye Myopia care needs of the public through clinical care, research, and education, all of which enhance the quality of life. OPTOMETRIC CLINICAL PRACTICE GUIDELINE CARE OF THE PATIENT WITH MYOPIA Reference Guide for Clinicians Prepared by the American Optometric Association Consensus Panel on Care of the Patient with Myopia: David A. Goss, O.D., Ph.D., Principal Author Theodore P. Grosvenor, O.D., Ph.D. Jeffrey T. Keller, O.D., M.P.H. Wendy Marsh-Tootle, O.D., M.S. Thomas T. Norton, Ph.D. Karla Zadnik, O.D., Ph.D. Reviewed by the AOA Clinical Guidelines Coordinating Committee: John F. Amos, O.D., M.S., Chair Kerry L. Beebe, O.D. Jerry Cavallerano, O.D., Ph.D.
    [Show full text]
  • The Relationship Between Myopia and Ocular Alignment Among Rural Adolescents
    Open Journal of Preventive Medicine, 2014, 4, 834-843 Published Online November 2014 in SciRes. http://www.scirp.org/journal/ojpm http://dx.doi.org/10.4236/ojpm.2014.411094 The Relationship between Myopia and Ocular Alignment among Rural Adolescents Li-Ju Lai1,2,3, Wei-Hsiu Hsu2,3, Chien-Neng Kuo1,3, Rei-Mei Hong4, Mei-Yen Chen5* 1Department of Ophthalmology, Chang Gang Memorial Hospital, Taoyuan, Taiwan 2Sports Medicine Center, Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan 3School of Medicine, Chang Gang University, Taoyuan, Taiwan 4Nursing Department, Chang Gung University of Science and Technology, Puzi City, Taiwan 5College of Nursing, Chang Gung University of Science and Technology, Puzi City, Taiwan Email: [email protected], [email protected], [email protected], [email protected], *[email protected] Received 18 September 2014; revised 19 October 2014; accepted 6 November 2014 Copyright © 2014 by authors and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY). http://creativecommons.org/licenses/by/4.0/ Abstract Purpose: The prevalence of myopia in school-age children and rural area in Taiwan has increased dramatically. The aim of this study was to explore the associated factors of myopia in rural ado- lescents. Methods: A cross sectional design with a rural junior high student was invited to partici- pate in this study. The relationship between refraction error (RE), spectacle fitting condition, and ocular alignment was determined by stereoacuity. The RE was determined using autorefractor. The ocular alignment was evaluated by cover-uncover test.
    [Show full text]
  • An Unusual Case of Myopic Shift Post Acquired Brain Injury Nada ONTROL
    Generating value “ CASE REPORT for optometrists “ SUPPORT An unusual case of myopic shift post acquired brain injury SAVINGS BY FARRAH F. SUNDERJI, OD & surgery and brain tumours; or a Farrah F. Sunderji, O.D. CATHERINE HEYMAN, OD, FAAO, traumatic brain injury (TBI) result- Resident, Pediatric Optometry CE Seminars FCOVD ing from an external insult (Table and Vision Therapy Centralized 1).3,4 Males are more at risk for Southern California College Billing both a CVA and TBI. Using Table of Optometry Background 1 for classification purposes, this 2006-2007 n the United States, approx- case report illustrates an unusual Catherine Heyman, O.D., Discount imately one person every 16 presentation of myopic shift post AUTONOMY Local Presence I F.A.A.O, FCOVD seconds suffers some form of ac- ABI due to the presence of mul- 1 Southern California College quired brain injury (ABI). An ABI tiple brain tumours, brain surgery of Optometry opto.com results from an event that occurs for removal of the tumours, shunt Faculty Advisor Optosys®2 suddenly and results in neurologi- placement for hydrocephalus, and Training cal dysfunctions.2 The two major a CVA post-surgery. Securo Vision CONTROL events that cause an ABI include Ocular and visual problems are In memory of the late Michael Rouse,OD VALUE an internal insult such as a cerebro- frequent consequences of an ABI. Web site vascular accident (CVA), brain Cohen1 explains that following a creation Marketing RÉSUMÉ UN CAS INHABITUEL D’ÉCART MYOPIQUE SURVENANT À LA SUITE D’UNE LÉSION CÉRÉBRALE ACQUISE Financing Contexte et 22,2 mmol/L; le patient a fait un AVC Lors d’une visite de suivi un mois plus tard, Des problèmes oculovisuels surviennent après l’intervention, ce qui a causé une sa meilleure acuité visuelle corrigée à une fréquemment après une lésion hémiparésie du côté gauche; un shunt a été distance s’était améliorée à 6/60 dans les cérébrale acquise (LCA).
    [Show full text]