Systemic Conditions Refractive Disorders
Total Page：16
File Type：pdf, Size：1020Kb
Load more
Recommended publications
-
Pediatric Anisometropia: Case Series and Review
Pediatric Anisometropia: tacles, vision therapy, and occlusion. Case two Case Series and Review is anisometropia caused by organic vision loss from optic neuritis early in life. Case three is John D. Tassinari OD, FAAO, FCOVD an infant with hyperopic anisometropia and Diplomate Binocular Vision esotropia. The esotropia did not respond to Perception and Pediatric Optometry, spectacles and home based vision therapy. American Academy of Optometry Neonatal high bilateral hyperopia that Associate Professor Western converted to anisometropia because of early University of Health Sciences onset cosmetically invisible unilateral esotropia College of Optometry is speculated. Case four describes a boy Pomona, California diagnosed with hyperopic anisometropia at age 11 months coincident with a diagnosis of pseudoesotropia. His compliance with ARTICLE prescribed spectacles was spotty until age three years. An outstanding visual outcome ABSTRACT was achieved by age five years with spectacles Background only (no occlusion therapy). Case five concerns The etiology and natural course and history a boy who acquired hyperopic anisometropia of pediatric anisometropia are incompletely because one eye experienced increasing understood. This article reviews the literature hyperopia during his toddler years. His regarding pediatric anisometropia with much response to treatment, spectacles and part of the review integrated into a case series. time occlusion with home vision therapy, was The review and case reports are intended to outstanding. Case six is an infant diagnosed elevate clinical understanding of pediatric with 2.50 diopters of hyperopic anisometropia anisometropia including and especially at age six months. Monocular home based treatment outcomes. vison developmental activities, not glasses, were prescribed. Her anisometropia vanished Case Reports three months later. -
Contrast Sensitivity and Visual Acuity Among the Elderly
Contrast Sensitivity and Visual Acuity among the Elderly THESIS Presented in Partial Fulfillment of the Requirements for the Degree Master of Science in the Graduate School of The Ohio State University By Mawada Osman Graduate Program in Vision Science The Ohio State University 2020 Master's Examination Committee: Angela M. Brown, PhD, Advisor Bradley E. Dougherty, OD, PhD Heidi A. Wagner, OD, MPH Copyright by Mawada Osman 2020 Abstract Purpose: To establish the clinical utility and strengthen the validity of the Ohio Contrast Cards (OCC), expand the use of the OCC in a healthy elderly population, and form a baseline dataset of patients to be compared to patients with dementia. Method: Participants ages 65 and over (N = 51) were recruited from the Ohio State University Primary Vision Care (PVC). We assessed the visual function of each patient using four visual tests which include: OCC, Pelli-Robson Chart (PR), Teller Acuity Cards (TAC) and Clear Chart. The contrast sensitivity tests (OCC and PR) were assessed twice, once by each tester. The PR contrast levels were also evaluated at two different distances 1 meter and 3 meters (0.50 meter if visual acuity worse than 6.0 cy/cm). Cognitive abilities were evaluated using the 6-Item Cognitive Impairment Test (6-CIT). Results: A significant effect of test was revealed (p < 0.005), in favor of OCC, yielding consistently higher average LogCS scores than PR, average difference of 0.412 LogCS. The PR and OCC revealed similar repeatability with 95% LoA of ± 0.28 log units and 95% LoA of ± 0.27 log units, respectively. -
Multipurpose Conical Orbital Implant in Evisceration
Ophthalmic Plastic and Reconstructive Surgery Vol. 21, No. 5, pp 376–378 ©2005 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc. Multipurpose Conical Orbital Implant in Evisceration Harry Marshak, M.D., and Steven C. Dresner, M.D. Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, U.S.A. Purpose: To evaluate the safety and efficacy of the porous polyethylene multipurpose conical orbital implant for use in evisceration. Methods: A retrospective review of 31 eyes that underwent evisceration and received the multipurpose conical orbital implant. The orbits were evaluated at 1 week, 1 month, and 6 months after final prosthetic fitting for implant exposure, superior sulcus deformity, and prosthetic motility. Results: There were no cases of extrusion, migration, or infection. All patients had a good cosmetic result after final prosthetic fitting. Prosthetic motility was good in all patients. Exposure developed in one eye (3%) and a superior sulcus deformity developed in one eye (3%). Conclusions: Placement of an multipurpose conical orbital implant in conjunction with evisceration is a safe and effective treatment for blind painful eye that achieves good motility and a good cosmetic result. visceration has proved to be effective for the treat- forms anteriorly to the sclera to be closed over it, without Ement of blind painful eye from phthisis bulbi or crowding the fornices, and extends posteriorly through endophthalmitis. By retaining the sclera in its anatomic the posterior sclerotomies, providing needed volume to natural position, evisceration has the advantage of allow- the posterior orbit. ing the insertions of the extraocular muscles to remain intact, promoting better motility. -
Stroke and Transient Ischaemic Attacks
53454ournal ofNeurology, Neurosurgery, and Psychiatry 1994;57:534-543 J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.57.5.534 on 1 May 1994. Downloaded from NEUROLOGICAL MANAGEMENT Stroke and transient ischaemic attacks Peter Humphrey The management of stroke is expensive and ANATOMY accounts for about 5% of NHS hospital costs. Carotid v vertebrobasilar arterial territory Stroke is the commonest cause of severe Carotid-Classifying whether a stroke is in the physical disability. About 100 000 people territory of the carotid or vertebrobasilar suffer a first stroke each year in England and arteries is important, especially if the patient Wales. It is important to emphasise that makes a good recovery. Carotid endarterec- around 20-25% of all strokes affects people tomy is of proven value in those with carotid under 65 years of age. The annual incidence symptoms. Carotid stroke usually produces of stroke is two per 1000.' About 10% of all hemiparesis, hemisensory loss, or dysphasia. patients suffer a recurrent stroke within one Apraxia and visuospatial problems may also year. The prevalence of stroke shows that occur. If there is a severe deficit, there may there are 250 000 in England and Wales. also be an homonymous hemianopia and gaze Each year approximately 60 000 people are palsy. Episodes of amaurosis fugax or central reported to die of stroke; this represents retinal artery occlusion are also carotid about 12% of all deaths. Only ischaemic events. heart disease and cancer account for more Homer's syndrome can occur because of deaths. This means that in an "average" dis- damage to the sympathetic fibres in the trict health authority of 250 000 people, there carotid sheath. -
Binocular Vision Disorders Prescribing Guidelines
Prescribing for Preverbal Children Valerie M. Kattouf O.D. FAAO, FCOVD Illinois College of Optometry Associate Professor Prescribing for Preverbal Children Issues to consider: Age Visual Function Refractive Error Norms Amblyogenic Risk Factors Birth History Family History Developmental History Emmetropization A process presumed to be operative in producing a greater frequency of occurrence of emmetropia than would be expected in terms of chance distribution, as may be explained by postulating that a mechanism coordinates the formation and the development of the various components of the human eye which contribute to the total refractive power Emmetropization Passive process = nature and genetics 60% chance of myopia if 2 parents myopic (Ciuffrieda) Active process = mediated by blur and visual system compensates for blur Refractive Error Norms Highest rate of emmetropization – 1st 12-17 months Hyperopia Average refractive error in infants = +2 D > 1.50 diopters hyperopia at 5 years old – often remain hyperopic Refractive Error Norms Myopia 25% of infants are myopic Myopic Newborns (Scharf) @ 7 years 54% still myopic @ 7 years 46% emmetropic @ 7 years no hyperopia Refractive Error Norms Astigmatism Against the rule astigmatism more prevalent switches to with-the-rule with development At 3 1/2 years old astigmatism is at adult levels INFANT REFRACTION NORMS AGE SPHERE CYL 0-1mo -0.90+/-3.17 -2.02+/-1.43 2-3mo -0.47+/-2.28 -2.02+/-1.17 4-6mo -0.00+/-1.31 -2.20+/-1.15 6-9mo +0.50+/-0.99 -2.20+/-1.15 9-12mo +0.60+/-1.30 -1.64+/-0.62 -
Ophthalmological Findings in Children and Adolescents with Silver Russell
Ophthalmological findings in children and adolescents with Silver Russell Syndrome Marita Andersson Gronlund, Jovanna Dahlgren, Eva Aring, Maria Kraemer, Ann Hellstrom To cite this version: Marita Andersson Gronlund, Jovanna Dahlgren, Eva Aring, Maria Kraemer, Ann Hellstrom. Oph- thalmological findings in children and adolescents with Silver Russell Syndrome. British Journal of Ophthalmology, BMJ Publishing Group, 2010, 95 (5), pp.637. 10.1136/bjo.2010.184457. hal- 00588358 HAL Id: hal-00588358 https://hal.archives-ouvertes.fr/hal-00588358 Submitted on 23 Apr 2011 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. Ophthalmological findings in children and adolescents with Silver Russell Syndrome M Andersson Grönlund, MD, PhD1, J Dahlgren, MD, PhD2, E Aring, CO, PhD1, M Kraemer, MD1, A Hellström, MD, PhD1 1Institute of Neuroscience and Physiology/Ophthalmology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden. 2Institute for the Health of Women and Children, Gothenburg Paediatric Growth Research Centre (GP-GRC), The Sahlgrenska -
Visual Performance of Scleral Lenses and Their Impact on Quality of Life In
A RQUIVOS B RASILEIROS DE ORIGINAL ARTICLE Visual performance of scleral lenses and their impact on quality of life in patients with irregular corneas Desempenho visual das lentes esclerais e seu impacto na qualidade de vida de pacientes com córneas irregulares Dilay Ozek1, Ozlem Evren Kemer1, Pinar Altiaylik2 1. Department of Ophthalmology, Ankara Numune Education and Research Hospital, Ankara, Turkey. 2. Department of Ophthalmology, Ufuk University Faculty of Medicine, Ankara, Turkey. ABSTRACT | Purpose: We aimed to evaluate the visual quality CCS with scleral contact lenses were 0.97 ± 0.12 (0.30-1.65), 1.16 performance of scleral contact lenses in patients with kerato- ± 0.51 (0.30-1.80), and 1.51 ± 0.25 (0.90-1.80), respectively. conus, pellucid marginal degeneration, and post-keratoplasty Significantly higher contrast sensitivity levels were recorded astigmatism, and their impact on quality of life. Methods: with scleral contact lenses compared with those recorded with We included 40 patients (58 eyes) with keratoconus, pellucid uncorrected contrast sensitivity and spectacle-corrected contrast marginal degeneration, and post-keratoplasty astigmatism who sensitivity (p<0.05). We found the National Eye Institute Visual were examined between October 2014 and June 2017 and Functioning Questionnaire overall score for patients with scleral fitted with scleral contact lenses in this study. Before fitting contact lens treatment to be significantly higher compared with scleral contact lenses, we noted refraction, uncorrected dis- that for patients with uncorrected sight (p<0.05). Conclusion: tance visual acuity, spectacle-corrected distance visual acuity, Scleral contact lenses are an effective alternative visual correction uncorrected contrast sensitivity, and spectacle-corrected contrast method for keratoconus, pellucid marginal degeneration, and sensitivity. -
Treatment of Congenital Ptosis
13 Review Article Page 1 of 13 Treatment of congenital ptosis Vladimir Kratky1,2^ 1Department of Ophthalmology, Queen’s University, Kingston, Canada; 21st Medical Faculty, Charles University, Prague, Czech Republic Correspondence to: Vladimir Kratky, BSc, MD, FRCSC, DABO. Associate Professor of Ophthalmology, Director of Ophthalmic Plastic and Orbital Surgery, Oculoplastics Fellowship Director, Queen’s University, Kingston, Canada; 1st Medical Faculty, Charles University, Prague, Czech Republic. Email: [email protected]. Abstract: Congenital ptosis is an abnormally low position of the upper eyelid, with respect to the visual axis in the primary gaze. It can be present at birth or manifest itself during the first year of life and can be bilateral or unilateral. Additionally, it may be an isolated finding or part of a constellation of signs of a specific syndrome or systemic associations. Depending on how much it interferes with the visual axis, it may be considered as a functional or a cosmetic condition. In childhood, functional ptosis can lead to deprivation amblyopia and astigmatism and needs to be treated. However, even mild ptosis with normal vision can lead to psychosocial problems and correction is also advised, albeit on a less urgent basis. Although, patching and glasses can be prescribed to treat the amblyopia, the mainstay of management is surgical. There are several types of surgical procedure available depending on the severity and etiology of the droopy eyelid. The first part of this paper will review the different categories of congenital ptosis, including more common associated syndromes. The latter part will briefly cover the different surgical approaches, with emphasis on how to choose the correct condition. -
Clinicalguidelines
Postgrad MedJ7 1995; 71: 577-584 © The Fellowship of Postgraduate Medicine, 1995 Clinical guidelines Postgrad Med J: first published as 10.1136/pgmj.71.840.577 on 1 October 1995. Downloaded from Management of transient ischaemic attacks and stroke PRD Humphrey Summary The management of stroke and transient ischaemic attacks (TIAs) consumes The management of stroke and about 500 of NHS hospital costs. Stroke is the commonest cause of severe transient ischaemic attacks physical disability with an annual incidence of two per 1000.1 In an 'average' (TIAs) has changed greatly in the district general hospital of 250 000 people there will be 500 first strokes in one last two decades. The importance year with a prevalence of about 1500. TIAs are defined as acute, focal of good blood pressure control is neurological symptoms, resulting from vascular disease which resolve in less the hallmark of stroke preven- than 24 hours. The incidence of a TIA is 0.5 per 1000. tion. Large multicentre trials Stroke is not a diagnosis. It is merely a description of a symptom complex have proven beyond doubt the thought to have a vascular aetiology. It is important to classify stroke according value of aspirin in TIAs, warfarin to the anatomy ofthe lesion, its timing, aetiology and pathogenesis. This will help in patients with atrial fibrillation to decide the most appropriate management. and embolic cerebrovascular symptoms, and carotid endarter- Classification of stroke ectomy in patients with carotid TIAs. There seems little doubt Many neurologists have described erudite vascular syndromes in the past. Most that patients managed in acute ofthese are oflittle practical use. -
Transient Monocular Visual Loss
Transient Monocular Visual Loss VALÉRIE BIOUSSE, MD AND JONATHAN D. TROBE, MD ● PURPOSE: To provide a practical update on the diagno- when most episodes of TMVL do not cause total loss of sis and management of transient monocular visual loss vision.2 (TMVL). The most important step in evaluating a patient with ● DESIGN: Perspective. visual loss is to establish whether the visual loss is ● METHODS: Review of the literature. monocular or binocular.2,5 Monocular visual loss always ● RESULTS: TMVL is an important clinical symptom. It results from lesions anterior to the chiasm (the eye or the has numerous causes but most often results from tran- optic nerve), whereas binocular visual loss results from sient retinal ischemia. It may herald permanent visual lesions of both eyes or optic nerves, or, more likely, of the loss or a devastating stroke, and patients with TMVL chiasm or retrochiasmal visual pathway. should be evaluated urgently. A practical approach to the Deciding whether an episode of abrupt visual loss evaluation of the patient with TMVL must be based on occurred in one eye or both is not always easy. Very few the patient’s age and the suspected underlying etiology. patients realize that binocular hemifield (homonymous) In the older patient, tests should be performed to inves- visual field loss affects the fields of both eyes. They will tigate giant cell arteritis, atherosclerotic large vessel usually localize it to the eye that lost its temporal field. The disease, and cardiac abnormalities. In the younger pa- best clues to the fact that visual loss was actually binocular tient, TMVL is usually benign and the evaluation should are reading impairment (monocular visual loss does not be tailored to the particular clinical setting. -
Approved and Unapproved Abbreviations and Symbols For
Facility: Illinois College of Optometry and Illinois Eye Institute Policy: Approved And Unapproved Abbreviations and Symbols for Medical Records Manual: Information Management Effective: January 1999 Revised: March 2009 (M.Butz) Review Dates: March 2003 (V.Conrad) March 2008 (M.Butz) APPROVED AND UNAPPROVED ABBREVIATIONS AND SYMBOLS FOR MEDICAL RECORDS PURPOSE: To establish a database of acceptable ocular and medical abbreviations for patient medical records. To list the abbreviations that are NOT approved for use in patient medical records. POLICY: Following is the list of abbreviations that are NOT approved – never to be used – for use in patient medical records, all orders, and all medication-related documentation that is either hand-written (including free-text computer entry) or pre-printed: DO NOT USE POTENTIAL PROBLEM USE INSTEAD U (unit) Mistaken for “0” (zero), the Write “unit” number “4”, or “cc” IU (international unit) Mistaken for “IV” (intravenous) Write “international unit” or the number 10 (ten). Q.D., QD, q.d., qd (daily) Mistaken for each other Write “daily” Q.O.D., QOD, q.o.d., qod Period after the Q mistaken for Write (“every other day”) (every other day) “I” and the “O” mistaken for “I” Trailing zero (X.0 mg) ** Decimal point is missed. Write X mg Lack of leading zero (.X mg) Decimal point is missed. Write 0.X mg MS Can mean morphine sulfate or Write “morphine sulfate” or magnesium sulfate “magnesium sulfate” MSO4 and MgSO4 Confused for one another Write “morphine sulfate” or “magnesium sulfate” ** Exception: A trailing zero may be used only where required to demonstrate the level of precision of the value being reported, such as for laboratory results, imaging studies that report size of lesions, or catheter/tube sizes. -
Management of Vith Nerve Palsy-Avoiding Unnecessary Surgery
MANAGEMENT OF VITH NERVE PALSY-AVOIDING UNNECESSARY SURGERY P. RIORDAN-E VA and J. P. LEE London SUMMARY for unrecovered VIth nerve palsy must involve a trans Unresolved Vlth nerve palsy that is not adequately con position procedure3.4. The availability of botulinum toxin trolled by an abnormal head posture or prisms can be to overcome the contracture of the ipsilateral medial rectus 5 very suitably treated by surgery. It is however essential to now allows for full tendon transplantation techniques -7, differentiate partially recovered palsies, which are with the potential for greatly increased improvements in amenable to horizontal rectus surgery, from unrecovered final fields of binocular single vision, and deferment of palsies, which must be treated initially by a vertical any necessary surgery to the medial recti, which is also muscle transposition procedure. Botulinum toxin is a likely to improve the final outcome. valuable tool in making this distinction. It also facilitates This study provides definite evidence, from a large full tendon transposition in unrecovered palsies, which series of patients, of the potential functional outcome from appears to produce the best functional outcome of all the the surgical treatment of unresolved VIth nerve palsy, transposition procedures, with a reduction in the need for together with clear guidance as to the forms of surgery that further surgery. A study of the surgical management of 12 should be undertaken in specific cases. The fundamental patients with partially recovered Vlth nerve palsy and 59 role of botulinum toxin in establishing the degree of lateral patients with unrecovered palsy provides clear guidelines rectus function and hence the correct choice of initial sur on how to attain a successful functional outcome with the gery, and as an adjunct to transposition surgery for unre minimum amount of surgery.