A Guide to Common Visual Terms
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Differentiate Red Eye Disorders
Introduction DIFFERENTIATE RED EYE DISORDERS • Needs immediate treatment • Needs treatment within a few days • Does not require treatment Introduction SUBJECTIVE EYE COMPLAINTS • Decreased vision • Pain • Redness Characterize the complaint through history and exam. Introduction TYPES OF RED EYE DISORDERS • Mechanical trauma • Chemical trauma • Inflammation/infection Introduction ETIOLOGIES OF RED EYE 1. Chemical injury 2. Angle-closure glaucoma 3. Ocular foreign body 4. Corneal abrasion 5. Uveitis 6. Conjunctivitis 7. Ocular surface disease 8. Subconjunctival hemorrhage Evaluation RED EYE: POSSIBLE CAUSES • Trauma • Chemicals • Infection • Allergy • Systemic conditions Evaluation RED EYE: CAUSE AND EFFECT Symptom Cause Itching Allergy Burning Lid disorders, dry eye Foreign body sensation Foreign body, corneal abrasion Localized lid tenderness Hordeolum, chalazion Evaluation RED EYE: CAUSE AND EFFECT (Continued) Symptom Cause Deep, intense pain Corneal abrasions, scleritis, iritis, acute glaucoma, sinusitis, etc. Photophobia Corneal abrasions, iritis, acute glaucoma Halo vision Corneal edema (acute glaucoma, uveitis) Evaluation Equipment needed to evaluate red eye Evaluation Refer red eye with vision loss to ophthalmologist for evaluation Evaluation RED EYE DISORDERS: AN ANATOMIC APPROACH • Face • Adnexa – Orbital area – Lids – Ocular movements • Globe – Conjunctiva, sclera – Anterior chamber (using slit lamp if possible) – Intraocular pressure Disorders of the Ocular Adnexa Disorders of the Ocular Adnexa Hordeolum Disorders of the Ocular -
Pattern of Vitreo-Retinal Diseases at the National Referral Hospital in Bhutan: a Retrospective, Hospital-Based Study Bhim B
Rai et al. BMC Ophthalmology (2020) 20:51 https://doi.org/10.1186/s12886-020-01335-x RESEARCH ARTICLE Open Access Pattern of vitreo-retinal diseases at the national referral hospital in Bhutan: a retrospective, hospital-based study Bhim B. Rai1,2* , Michael G. Morley3, Paul S. Bernstein4 and Ted Maddess1 Abstract Background: Knowing the pattern and presentation of the diseases is critical for management strategies. To inform eye-care policy we quantified the pattern of vitreo-retinal (VR) diseases presenting at the national referral hospital in Bhutan. Methods: We reviewed all new patients over three years from the retinal clinic of the Jigme Dorji Wangchuck National Referral Hospital. Demographic data, presenting complaints and duration, treatment history, associated systemic diseases, diagnostic procedures performed, and final diagnoses were quantified. Comparisons of the expected and observed frequency of gender used Chi-squared tests. We applied a sampling with replacement based bootstrap analysis (10,000 cycles) to estimate the population means and the standard errors of the means and standard error of the 10th, 25th, 50th, 75th and 90th percentiles of the ages of the males and females within 20-year cohorts. We then applied t-tests employing the estimated means and standard errors. The 2913 subjects insured that the bootstrap estimates were statistically conservative. Results: The 2913 new cases were aged 47.2 ± 21.8 years. 1544 (53.0%) were males. Housewives (953, 32.7%) and farmers (648, 22.2%) were the commonest occupations. Poor vision (41.9%), screening for diabetic and hypertensive retinopathy (13.1%), referral (9.7%), sudden vision loss (9.3%), and trauma (8.0%) were the commonest presenting symptoms. -
Controversies in Scleral Lenses 2019 Curvature Versus Elevation
Controversies in Scleral Lenses Normal Keratoconus PMD Keratoglobus 2019 Curvature versus Elevation Axial Display Elevation Map Power Map Height Map Axial Display Elevation Display Patient CB Moderate KC Axial Display Map +180um +180 +379 +379um Elevation Display -110 - 276 Elevation Map 655 Above the 290 microns Micron Sphere Height -276um Differential Depression Below the -110um Sphere N = 87 Patients 127 CL Fits Less than 350um Greater than 350um Patients with 350um or less of corneal elevation difference (along the greatest meridian of change) have an 88.2% chance of success with a corneal GP lens. The Re-Birth of Scleral Lenses Glass Scleral Lenses 1887 Molding Glass Scleral Lenses Average 8.5 High DK Scleral Materials Traditional Corneal / Scleral • Menicon Z Dk = 163 Shape • B & L, Boston XO2 DK = 141 • Contamac, Optimum Extreme DK = 125 • B & L, Boston XO DK = 100 • Paragon HDS 100 DK = 100 • Contamac, Optimum Extra DK = 100 • Lagado, Tyro -97 DK = 97 Scleral Shape Cone Angle Circa 1948 Klaus Pfortner New Understandings Argentina Scleral Lens Fitting Objectives Anatomy of a Scleral Lens 1. Central Vault Zone (250 to 400 microns) 2. Peripheral Lift Zone 4 3 2 1 2 3 4 3. Limbal Lift Zone 4. Scleral Landing Zone Ocular Surface Disease Scleral Lens Indications Scleral Irregular Astigmatism Lens • Keratoconus Indications • Pellucid Marginal Degeneration • Post Corneal Trauma • Post keratoplasty • Post K-Pro • Post Refractive Surgery RK, PRK and LASIK • Post HSV and HZV • Athletes • GP stability (rocking) issues Corneal Irregularity -
RETINAL DISORDERS Eye63 (1)
RETINAL DISORDERS Eye63 (1) Retinal Disorders Last updated: May 9, 2019 CENTRAL RETINAL ARTERY OCCLUSION (CRAO) ............................................................................... 1 Pathophysiology & Ophthalmoscopy ............................................................................................... 1 Etiology ............................................................................................................................................ 2 Clinical Features ............................................................................................................................... 2 Diagnosis .......................................................................................................................................... 2 Treatment ......................................................................................................................................... 2 BRANCH RETINAL ARTERY OCCLUSION ................................................................................................ 3 CENTRAL RETINAL VEIN OCCLUSION (CRVO) ..................................................................................... 3 Pathophysiology & Etiology ............................................................................................................ 3 Clinical Features ............................................................................................................................... 3 Diagnosis ......................................................................................................................................... -
Outer Retina Changes on Optical Coherence Tomography in Vitamin a Defciency Meghan K
Berkenstock et al. Int J Retin Vitr (2020) 6:23 https://doi.org/10.1186/s40942-020-00224-1 International Journal of Retina and Vitreous CASE REPORT Open Access Outer retina changes on optical coherence tomography in vitamin A defciency Meghan K. Berkenstock, Charles J. Castoro and Andrew R. Carey* Abstract Background: Vitamin A defciency is rare in the United States and can be missed in patients with malabsorption syn- dromes without a high dose of suspicion. Ocular complications of hypovitaminosis A include xerosis and nyctalopia, and to a lesser extent reduction in visual acuity and color vision. Outer retinal changes, as seen on spectral domain optic coherence tomography (SD-OCT), in patients with vitamin A defciency have previously not been documented. Case presentation: We present two cases with symptoms of severe nyctalopia who were subsequently diagnosed with severe Vitamin A defciency and their unique fndings on SD-OCT of outer nuclear layer difuse thinning with irregular appearance of the interdigitating zone and the ellipsoid zone as well as normalization after vitamin A supplementation. Conclusions: Outer nuclear layer thinning and disruption of the outer retinal bands on SD-OCT are reversible with correction of vitamin A defciency. Improvement in visual acuity, color vision, and nyctalopia are possible with early diagnosis and appropriate treatment. Keywords: Vitamin A defciency, Optical coherence tomography, Nyctalopia Background reverse ocular complications prior to permanent vision Most commonly seen in regions with food insecurity, loss [16, 24, 25]. Only a few reports have described the nutritional defciencies, or restricted diets, vitamin A photoreceptor changes on spectral domain optical coher- defciency is rare in developed countries [1–9]. -
Action and Perception Are Temporally Coupled by a Common Mechanism That Leads to a Timing Misperception
The Journal of Neuroscience, January 28, 2015 • 35(4):1493–1504 • 1493 Behavioral/Cognitive Action and Perception Are Temporally Coupled by a Common Mechanism That Leads to a Timing Misperception Elena Pretegiani,1,2 Corina Astefanoaei,3 XPierre M. Daye,1,4 Edmond J. FitzGibbon,1 Dorina-Emilia Creanga,3 Alessandra Rufa,2 and XLance M. Optican1 1Laboratory of Sensorimotor Research, NEI, NIH, DHHS, Bethesda, Maryland, 20892-4435, 2EVA-Laboratory, University of Siena, 53100 Siena, Italy, 3Alexandru Ioan Cuza University, Physics Faculty, 700506 Iasi, Romania, and 4Institut du cerveau et de la moelle´pinie e `re (ICM), INSERM UMRS 975, 75013 Paris, France We move our eyes to explore the world, but visual areas determining where to look next (action) are different from those determining what we are seeing (perception). Whether, or how, action and perception are temporally coordinated is not known. The preparation time course of an action (e.g., a saccade) has been widely studied with the gap/overlap paradigm with temporal asynchronies (TA) between peripheral target onset and fixation point offset (gap, synchronous, or overlap). However, whether the subjects perceive the gap or overlap, and when they perceive it, has not been studied. We adapted the gap/overlap paradigm to study the temporal coupling of action and perception. Human subjects made saccades to targets with different TAs with respect to fixation point offset and reported whether they perceived the stimuli as separated by a gap or overlapped in time. Both saccadic and perceptual report reaction times changed in the same way as a function of TA. The TA dependencies of the time change for action and perception were very similar, suggesting a common neural substrate. -
The Complexity and Origins of the Human Eye: a Brief Study on the Anatomy, Physiology, and Origin of the Eye
Running Head: THE COMPLEX HUMAN EYE 1 The Complexity and Origins of the Human Eye: A Brief Study on the Anatomy, Physiology, and Origin of the Eye Evan Sebastian A Senior Thesis submitted in partial fulfillment of the requirements for graduation in the Honors Program Liberty University Spring 2010 THE COMPLEX HUMAN EYE 2 Acceptance of Senior Honors Thesis This Senior Honors Thesis is accepted in partial fulfillment of the requirements for graduation from the Honors Program of Liberty University. ______________________________ David A. Titcomb, PT, DPT Thesis Chair ______________________________ David DeWitt, Ph.D. Committee Member ______________________________ Garth McGibbon, M.S. Committee Member ______________________________ Marilyn Gadomski, Ph.D. Assistant Honors Director ______________________________ Date THE COMPLEX HUMAN EYE 3 Abstract The human eye has been the cause of much controversy in regards to its complexity and how the human eye came to be. Through following and discussing the anatomical and physiological functions of the eye, a better understanding of the argument of origins can be seen. The anatomy of the human eye and its many functions are clearly seen, through its complexity. When observing the intricacy of vision and all of the different aspects and connections, it does seem that the human eye is a miracle, no matter its origins. Major biological functions and processes occurring in the retina show the intensity of the eye’s intricacy. After viewing the eye and reviewing its anatomical and physiological domain, arguments regarding its origins are more clearly seen and understood. Evolutionary theory, in terms of Darwin’s thoughts, theorized fossilization of animals, computer simulations of eye evolution, and new research on supposed prior genes occurring in lower life forms leading to human life. -
Cut-And-Assemble Paper Eye Model
CUT-AND-ASSEMBLE PAPER EYE MODEL Background information: This activity assumes that you have study materials available for your students. However, if you need a quick review of how the eye works, try one of these videos on YouTube. (Just use YouTube’s search feature with these key words.) “Anatomy and Function of the Eye: posted by Raphael Fernandez (2 minutes) “Human Eye” posted by Smart Learning for All (cartoon, 10 minutes) “A Journey Through the Human Eye” posted by Bausch and Lomb (2.5 minutes) “How the Eye Works” posted by AniMed (2.5 minutes) You will need: • copies of the pattern pages printed onto lightweight card stock (vellum bristol is fine, or 65 or 90 pound card stock) • scissors • white glue or good quality glue stick (I always advise against “school glue.”) • clear tape (I use the shiny kind, not the “invisible” kind, as I find the shiny kind more sticky.) • a piece of thin, clear plastic (a transparency [used in copiers] is fine, or a piece of recycled clear packaging as long as it is not too thick-- it should be fairly flimsy and bend very easily) • colored pencils: red for blood vessels and muscle, and brown/blue/green for coloring iris (your choice) (Also, you can use a few other colors for lacrimal gland, optic nerve, if you want to.) • thin permanent marker for a number labels on plastic parts (such as a very thin point Sharpie) Assembly: 1) After copying pattern pages onto card stock, cut out all parts. On the background page that says THE HUMAN EYE, cut away the black rectangles and trim the triangles at the bottom, as shown in picture above. -
Pterygium & Pinguecula
Dr. Anthony O. Roberts 9715 Medical Center Drive Pterygium & Pinguecula Suite 502 Rockville, MD 20850 A pterygium is a mass of fleshy tissue that Phone: 301-279-0600 E-mail: [email protected] grows over the cornea (the clear front window of the eye). It may remain small or may grow large enough to interfere with vision. A ptery- gium most commonly occurs on the inner cor- Eye Care Services ner of the eye, but it can appear on the outer Eye Exams corner as well. Glaucoma Testing & The exact cause of pterygia is not well understood. They occur more often Treatment in people who spend a lot of time outdoors, especially in sunny climates. Cataract Surgery Long-term exposure to sunlight, especially to ultraviolet (UV) rays, and Diabetic Evaluation chronic eye irritation from dry, dusty conditions seem to play an important LASIK Eye Surgery role. Dry eye also may contribute to pterygium. PRK Surgery Refractive Procedures When a pterygium becomes red and irritated, eyedrops or ointments can be used to help reduce the inflammation. If the pterygium grows rapidly or is Our Practice large enough to threaten sight, it can be removed surgically. At Shady Grove Ophthal- mology, we understand the Despite proper surgical removal, a pterygium may return, particularly in importance of your vision. young people. Protecting the eyes from excessive ultraviolet light with We are committed to offering proper sunglasses, avoiding dry, dusty conditions, and using artificial tears the highest quality eye care can also help. using the most state-of-the- art technologies. Dr. An- thony Roberts delivers pre- A pinguecula is a yellowish patch or bump on the white of the eye, most mium quality eye care and often on the side closest to the nose. -
Gibberman – Advances in Scleral Lens Technology
ADVANCES IN SCLERAL LENS TECHNOLOGY ALEX GIBBERMAN, OD, FAAO, FSLS 2020 EYECARE, LOVELAND, OHIO A BRIEF HISTORY OF THE WORLD…OF SCLERALS 16th century- Da Vinci concepts. Blown glass shell. No power. 1887-Muller brothers. Thinner blown glass shells 1888- Adolf Fick. Glass lenses first to treat k conus with correction. First to note corneal edema 1889- Dr. Kirstein is born! Also August Muller is first to use scleral to correct for high myopia HISTORY CONTINUED… 1890’s- The use of saline with scleral insertion is introduced 1912- Zeiss makes first diagnostic fitting set Also notable in 1912, Dr Zelczak is born! 1957-PMMA sclerals introduced. 1970s-John James Little and Arthur Irving first to use RGP sclerals 1983-RGP scleral materials updated by optometrist Don Ezekiel MODERN SCLERALS Between the mid 1980s and now, significant material and dk improvements have occurred. Late 1980s- Back toric optics were introduced to sclerals 1992- the first impression based, computer scanned and created lens was made in the UK 2013-EyePrintPro was developed to take an impression and match exact contour of the eye Current- multifocal optics, decentered optics, front toric and back toric optics, prism and higher order aberration correction are all possible Scleral topographers: Getting us closer to empirical fitting. We will discuss in more detail SPECIFICATIONS OF A MODERN SCLERAL LENS? Here is just one example Base Curve 7.50 Diameter 16.1 mm Sagittal Depth: 3500um Toric Peripheral curve, flatten horizontal meridian 100um steepen vertical meridian 200um Front toric overall power -400 -125 x 105 Multifocal Center ADD 2.5mm Zone +250 ADD Nasal microvault or notch to avoid pinguecula Material: Optimum Infinite Dk 200 needs hydropeg coating WHAT A CURRENT SCLERAL LOOKS LIKE SCLERAL TOPOGRAPHERS Eaglet- Eye surface profiler Pentacam- CSP Visionary Optics-Smap3D Latitude Focal Points Focal Points will allow the import of multiple types of scleral topography files such as Eaglet ESP, Pentacam CSP and sMap. -
The Evolution of Human Intelligence and the Coefficient of Additive Genetic Variance in Human Brain Size ⁎ Geoffrey F
Intelligence 35 (2007) 97–114 The evolution of human intelligence and the coefficient of additive genetic variance in human brain size ⁎ Geoffrey F. Miller a, , Lars Penke b a University of New Mexico, USA b Institut für Psychologie, Humboldt-Universität zu Berlin, Germany Received 3 November 2005; received in revised form 17 August 2006; accepted 18 August 2006 Available online 12 October 2006 Abstract Most theories of human mental evolution assume that selection favored higher intelligence and larger brains, which should have reduced genetic variance in both. However, adult human intelligence remains highly heritable, and is genetically correlated with brain size. This conflict might be resolved by estimating the coefficient of additive genetic variance (CVA) in human brain size, since CVAs are widely used in evolutionary genetics as indexes of recent selection. Here we calculate for the first time that this CVA is about 7.8, based on data from 19 recent MRI studies of adult human brain size in vivo: 11 studies on brain size means and standard deviations, and 8 studies on brain size heritabilities. This CVA appears lower than that for any other human organ volume or life-history trait, suggesting that the brain has been under strong stabilizing (average-is-better) selection. This result is hard to reconcile with most current theories of human mental evolution, which emphasize directional (more-is-better) selection for higher intelligence and larger brains. Either these theories are all wrong, or CVAs are not as evolutionarily informative as most evolutionary geneticists believe, or, as we suggest, brain size is not a very good index for understanding the evolutionary genetics of human intelligence. -
Retinitis Pigmentosa and Allied Disorders Yog Raj Sharma, P
JK SCIENCE REVIEW ARTICLE Retinitis Pigmentosa and Allied Disorders Yog Raj Sharma, P. Raja Rami Reddy, Deependra V. Singh Retinitis pigmentosa (RP) is a generic term for a group Visual field loss is insidious, progressive, peripheral of disorders characterized by hereditary diffuse usually and symmetric between two eyes (except x-linked RP bilaterally symmetrical progressive dysfunction, cell loss which can have bizarre and asymmetric patterns). In the and eventual atrophy of retina. Initially photoreceptors majority of patients the earliest defects are relative are involved and subsequently inner retina is damaged. scotomas in the periphery between 30 and 50 degrees Although both rods and cones are involved, damage to from fixation, which enlarge, deepen and coalesce to the rods is predominant. RP may be seen in isolation form a ring of visual field loss. As ring scotomas enlarge (Typical RP) or in association with systemic diseases. toward the far periphery, islands of relatively normal The reported prevalence of typical RP is approximately vision remain usually temporal but occasionally 1: 50000 worldwide. Most commonly 46% of the cases inferiorly. In typical RP the progression of visual loss is are sporadic with only one affected member in a given slow and relentless. Berson et al found that overall about family. X- linked recessive inheritance is least common, 4.6% of remaining visual field was lost per year (3). amounting to 8%. Autosomal dominant inheritance is Central visual loss found in 19% and recessive in 19%. The age of onset This can occur early in typical RP while significant and the natural history of the disease depend on the peripheral field remains cystoid macular edema, macular inheritance.