6269 Variation of the Response to the Optokinetic Drum Among Various Strain
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Wildlife Ophthalmology
Wildlife Ophthalmology DR. HEATHER REID TORONTO WILDLIFE CENTRE TORONTO, ON CANADA Why understand eyes? Wildlife need to have excellent vision to survive in the wild Eye related problems are common in wildlife admitted to rehabilitation centers What we will cover Anatomy of the eye Differences between birds and mammals The eye exam Recognizing common problems Prognosis Treatment options When to see the vet Anatomy Around the Eye: Muscles & nerves Skin Eye lids Nictitating eyelid Conjunctiva & sclera Tear glands & ducts Ossicles (birds) Anatomy Front of the Eye: Cornea Iris Pupil Ciliary body Anterior Chamber Aqueous humor Anatomy Back of the Eye: Lens Retina Optic nerve Choroid Pecten (birds) Posterior Chamber Vitreous humor Fundus of the Eye Mammal Eye Bird Eye The Avian Eye - Differences Small eye size in most birds and small pupil size makes it hard to examine Can control the size of their pupil Lower eyelid more developed The nictitating membrane spreads the tears allowing birds to blink less Moves horizontally across eye The Avian Eye - Differences Eyes are not as protected by skull Less muscles around eye so less eye movement Boney ossicles support the eye Three main eye shapes; flat, globose & tubular The Avian Eye - Differences Four different color receptors compared to the three in mammals means better color detail Can see in the ultraviolet range Higher flicker rate – can detect lights that flicker at more than 100 flashes per second (humans detect at 50) The Avian Eye - Differences In some species the eye -
Treacher Collins Prize Essay the Significance of Nystagmus
Eye (1989) 3, 816--832 Treacher Collins Prize Essay The Significance of Nystagmus NICHOLAS EVANS Norwich Introduction combined. The range of forms it takes, and Ophthalmology found the term v!to"[<xy!too, the circumstances in which it occurs, must be like many others, in classical Greece, where it compared and contrasted in order to under described the head-nodding of the wined and stand the relationships between nystagmus of somnolent. It first acquired a neuro-ophthal different aetiologies. An approach which is mological sense in 1822, when it was used by synthetic as well as analytic identifies those Goodl to describe 'habitual squinting'. Since features which are common to different types then its meaning has been refined, and much and those that are distinctive, and helps has been learned about the circumstances in describe the relationship between eye move which the eye oscillates, the components of ment and vision in nystagmus. nystagmus, and its neurophysiological, Nystagmus is not properly a disorder of eye neuroanatomic and neuropathological corre movement, but one of steady fixation, in lates. It occurs physiologically and pathologi which the relationship between eye and field cally, alone or in conjunction with visual or is unstable. The essential significance of all central nervous system pathology. It takes a types of nystagmus is the disturbance in this variety of different forms, the eyes moving relationship between the sensory and motor about one or more axis, and may be conjugate ends of the visual-oculomotor axis. Optimal or dysjugate. It can be modified to a variable visual performance requires stability of the degree by external (visual, gravitational and image on the retina, and vision is inevitably rotational) and internal (level of awareness affected by nystagmus. -
Faculdade De Medicina Veterinária
UNIVERSIDADE DE LISBOA Faculdade de Medicina Veterinária OCULAR BRACHYCEPHALIC SYNDROME Joana Veiga Costa CONSTITUIÇÃO DO JÚRI ORIENTADORA Doutora Maria Luísa Mendes Jorge Doutora Esmeralda Sofia da Costa Doutora Esmeralda Sofia da Costa Delgado Delgado Doutora Lisa Alexandra Pereira Mestrinho CO-ORIENTADORA Doutora Andrea Steinmetz 2019 LISBOA ___________________________________________________________________ UNIVERSIDADE DE LISBOA Faculdade de Medicina Veterinária OCULAR BRACHYCEPHALIC SYNDROME Joana Veiga Costa DISSERTAÇÃO DE MESTRADO INTEGRADO EM MEDICINA VETERINÁRIA CONSTITUIÇÃO DO JÚRI ORIENTADORA Doutora Maria Luísa Mendes Jorge Doutora Esmeralda Sofia da Costa Doutora Esmeralda Sofia da Costa Delgado Delgado Doutora Lisa Alexandra Pereira Mestrinho CO-ORIENTADORA Doutora Andrea Steinmetz 2019 LISBOA ___________________________________________________________________ ACKNOWLEDGEMENT I express my sincere gratitude towards my amazing parents for always supporting me in the pursue of my dreams. I am also immensely thankful to my sister and grandparents, not only for sharing this road with me, but also my whole life. I gratefully acknowledge and offer a special thanks to Professor Esmeralda Delgado for the valuable contribution, guidance, support and kind words throughout the last year. A big thank you to Dr. Susana Azinheira and Dr. Diogo Azinheira for all that I’ve learned during my stayings in your incredible hospital, and the opportunity to put my knowledge at practice. My warmest thanks to my colleagues Maria, Mariana, Pedro, Francisco, Diogo, Catarina, Cláudia, Inês, Sara and Marta for being by my side all these years and for their friendship. May it last forever. I am grateful to Ivo and Rafael for their guidance during the course, specially in the first year, when everything was completely new to me. -
Electroretinography 1 Electroretinography
Electroretinography 1 Electroretinography Electroretinography measures the electrical responses of various cell types in the retina, including the photoreceptors (rods and cones), inner retinal cells (bipolar and amacrine cells), and the ganglion cells. Electrodes are usually placed on the cornea and the skin near the eye, although it is possible to record the ERG from skin electrodes. During a recording, the patient's eyes are exposed to standardized stimuli and the resulting signal is displayed showing the time course of the signal's Maximal response ERG waveform from a dark adapted eye. amplitude (voltage). Signals are very small, and typically are measured in microvolts or nanovolts. The ERG is composed of electrical potentials contributed by different cell types within the retina, and the stimulus conditions (flash or pattern stimulus, whether a background light is present, and the colors of the stimulus and background) can elicit stronger response from certain components. If a flash ERG is performed on a dark-adapted eye, the response is primarily from the rod system and flash ERGs performed on a light adapted eye will reflect the activity of the cone system. To sufficiently bright flashes, the ERG will contain an A patient undergoing an electroretinogram a-wave (initial negative deflection) followed by a b-wave (positive deflection). The leading edge of the a-wave is produced by the photoreceptors, while the remainder of the wave is produced by a mixture of cells including photoreceptors, bipolar, amacrine, and Muller cells or Muller glia.[1] The pattern ERG, evoked by an alternating checkerboard stimulus, primarily reflects activity of retinal ganglion cells. -
Pediatric Ophthalmology/Strabismus 2017-2019
Academy MOC Essentials® Practicing Ophthalmologists Curriculum 2017–2019 Pediatric Ophthalmology/Strabismus *** Pediatric Ophthalmology/Strabismus 2 © AAO 2017-2019 Practicing Ophthalmologists Curriculum Disclaimer and Limitation of Liability As a service to its members and American Board of Ophthalmology (ABO) diplomates, the American Academy of Ophthalmology has developed the Practicing Ophthalmologists Curriculum (POC) as a tool for members to prepare for the Maintenance of Certification (MOC) -related examinations. The Academy provides this material for educational purposes only. The POC should not be deemed inclusive of all proper methods of care or exclusive of other methods of care reasonably directed at obtaining the best results. The physician must make the ultimate judgment about the propriety of the care of a particular patient in light of all the circumstances presented by that patient. The Academy specifically disclaims any and all liability for injury or other damages of any kind, from negligence or otherwise, for any and all claims that may arise out of the use of any information contained herein. References to certain drugs, instruments, and other products in the POC are made for illustrative purposes only and are not intended to constitute an endorsement of such. Such material may include information on applications that are not considered community standard, that reflect indications not included in approved FDA labeling, or that are approved for use only in restricted research settings. The FDA has stated that it is the responsibility of the physician to determine the FDA status of each drug or device he or she wishes to use, and to use them with appropriate patient consent in compliance with applicable law. -
Myopia: More Than a Refractive Error − Lasik and Retinal Dystrophies
MYOPIA: MORE THAN A REFRACTIVE ERROR − LASIK AND RETINAL DYSTROPHIES WALRAEDT S.1*, LEROY B.P.1,2*, KESTELYN P.H.1, DE LAEY J.J.1 SUMMARY SAMENVATTING Three patients who had undergone laser in situ Drie patiënten die een correctie van myopie hadden keratomileusis (LASIK) correction for myopia were ondergaan met laser in situ keratomileusis (LASIK) first seen because of suboptimal visual acuity (VA) werden onderzocht omwille van postoperatieve sub- and night blindness and/or photophobia. After a com- optimale visus en nachtblindheid en/of fotofobie. Na prehensive examination including psychophysical uitgebreid onderzoek met inbegrip van psychofysi- and electrophysiological tests, two of the three pa- sche en electrofysiologische testen werd een dia- tients were shown to suffer from a progressive cone- gnose van progressieve kegeltjes-staafjesdystrofie ge- rod dystrophy. The third patient had retinitis pig- steld bij twee patiënten. De derde patiënt leed aan mentosa. These cases illustrate the need for in depth retinitis pigmentosa. Deze gevallen illustreren de preoperative evaluation in myopic patients about to noodzaak van een doorgedreven preoperatief onder- undergo LASIK when signs or problems of night blind- zoek bij myope patiënten die LASIK zullen onder- ness and/or photophobia are present. gaan met klachten van nachtblindheid en fotofobie. KEY WORDS RÉSUMÉ Retinal dystrophy, cone-rod dystrophy, Trois patients sont présentés ayant été examinés pour retinitis pigmentosa, photophobia, night une acuité visuelle sous-optimale et une héméralo- blindness, laser in situ keratomileusis, pie et/ou photophobie, après correction d’une myo- preoperative evaluation pie suivant la technique du laser in situ keratomi- leusis (LASIK). Sur base d’une évaluation élaborée, MOTS-CLÉS y inclus des tests psychophysiques et éléctrophysio- logiques, un diagnostic de dystrophie des cônes et Dystrophie rétinienne, dystrophie de type bâtonnets a été établi chez deux patients. -
Provider Guide
Physician-Related Services/ Health Care Professional Services Provider Guide July 1, 2015 Physician-Related Services/Health Care Professional Services About this guide* This publication takes effect July 1, 2015, and supersedes earlier guides to this program. Washington Apple Health means the public health insurance programs for eligible Washington residents. Washington Apple Health is the name used in Washington State for Medicaid, the children's health insurance program (CHIP), and state- only funded health care programs. Washington Apple Health is administered by the Washington State Health Care Authority. What has changed? Subject Change Reason for Change Medical Policy Updates Added updates from the Health Technology Clinical In accordance with WAC Committee (HTCC) 182-501-0055, the agency reviews the recommendations of HTCC and decides whether to adopt the recommendations Bariatric surgeries Removed list of agency-approved COEs and added Clarification link to web page for approved COEs Update to EPA Removed CPT 80102 CPT Code Update 870000050 Added CPT 80302 Maternity and delivery – Added intro paragraph for clarification of when to Clarification Billing with modifiers bill using modifier GB. Also updated column headers for modifiers Immune globulins Replacing deleted codes Q4087, Q4088, Q4091, and Updating deleted codes Q4092 with J1568, J1569, J1572, and J1561 Bilateral cochlear implant EPA 870001365 fixed diagnosis code 398.18 Corrected typo Newborn care The agency pays a collection fee for a newborn Clarification metabolic screening panel. The screening kit is provided free from DOH. Vaccines/Toxoids Add language “Routine vaccines are administered Clarification (Immunizations) according to current Centers for Disease Control (CDC) advisory committee on immunization practices (ACIP) immunization schedule for adults and children in the United States.” Injectable and nasal flu Adding link to Injectable Fee Schedule for coverage Clarification vaccines details * This publication is a billing instruction. -
Assessment and Management of Infantile Nystagmus Syndrome
perim Ex en l & ta a l ic O p in l h t C h f Journal of Clinical & Experimental a o l m l a o n l r o Atilla, J Clin Exp Ophthalmol 2016, 7:2 g u y o J Ophthalmology 10.4172/2155-9570.1000550 ISSN: 2155-9570 DOI: Review Article Open Access Assessment and Management of Infantile Nystagmus Syndrome Huban Atilla* Department of Ophthalmology, Faculty of Medicine, Ankara University, Turkey *Corresponding author: Huban Atilla, Department of Ophthalmology, Faculty of Medicine, Ankara University, Turkey, Tel: +90 312 4462345; E-mail: [email protected] Received date: March 08, 2016; Accepted date: April 26, 2016; Published date: April 29, 2016 Copyright: © 2016 Atilla H. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract This article is a review of infantile nystagmus syndrome, presenting with an overview of the physiological nystagmus and the etiology, symptoms, clinical evaluation and treatment options. Keywords: Nystagmus syndrome; Physiologic nystagmus phases; active following of the stimulus results in poor correspondence between eye position and stimulus position. At higher velocity targets Introduction (greater than 100 deg/sec) optokinetic nystagmus can no longer be evoked. Unlike simple foveal smooth pursuit, OKN appears to have Nystagmus is a rhythmic, involuntary oscillation of one or both both foveal and peripheral retinal components [3]. Slow phase of the eyes. There are various classifications of nystagmus according to the nystagmus is for following the target and the fast phase is for re- age of onset, etiology, waveform and other characteristics. -
Prolonged Pursuit by Optokinetic Drum Testing in Asymptomatic Female Carriers of Novel FRMD7 Splice Mutation C.1050 ؉5GϾA
OPHTHALMIC MOLECULAR GENETICS SECTION EDITOR: JANEY L. WIGGS, MD, PhD Prolonged Pursuit by Optokinetic Drum Testing in Asymptomatic Female Carriers of Novel FRMD7 Splice Mutation c.1050 ؉5GϾA Arif O. Khan, MD; Jameela Shinwari, MSc; Latifa Al-Sharif, BSc; Dania S. Khalil, BSc; Nada Al Tassan, PhD Objective: To determine the genotype underlying sus- was identified in the 2 affected brothers and in the 3 asymp- pected X-linked infantile nystagmus in a family and to tomatic women only. Allele sharing analysis further con- correlate genotype with clinical examination in poten- firmed that the aunt’s phenotype was not related to the tial female carriers. FRMD7 variant, which was absent in 246 ethnic controls. Her phenotype was also not related to mutation in known Methods: Ophthalmic examination (ophthalmic, or- CFEOM genes (KIF21A, PHOX2A, TUBB3). thoptic, optokinetic [OKN] drum, and electrophysi- ologic when possible) and candidate gene analysis. Conclusions: Prolonged pursuit responses during OKN drum testing in asymptomatic female carriers is consis- Results: Two affected brothers had infantile nystagmus tent with the concept of infantile nystagmus being an ab- with no evidence of associated visual or neurological normally increased pursuit oscillation. Further studies disease. The symptomatic maternal aunt had infantile are required to determine the reproducibility of this po- nystagmus in addition to congenital fibrosis of the ex- tential female carrier sign. Rather than being FRMD7 re- traocular muscles (CFEOM) (bilateral hypotropia, exo- lated, nystagmus in the maternal aunt represented a sec- tropia, ptosis, almost complete ophthalmoplegia, and ond disease in this family, likely related to CFEOM. poorly reactive pupils). A sister, the mother, and the ma- ternal grandmother—all 3 of whom were asymptomatic— Clinical Relevance: Clinicians can use the OKN drum had delayed corrective saccades (prolonged pursuit) dur- to assess obligate female carriers in a family suspected ing OKN drum testing. -
Pediatric Hearing Loss and Cochlear Implant Update Disclosure
3/27/2014 Pediatric Hearing Loss and Cochlear Implant Update David H. Chi, MD Children’s Hospital of Pittsburgh Medical Director, Hearing Center April 25, 2014 Fourth Annual ENT for the PA-C | April 24-27, 2014 | Pittsburgh, PA Disclosure • Nothing to disclose Fourth Annual ENT for the PA-C | April 24-27, 2014 | Pittsburgh, PA Learning Objectives 1. Review etiologies and various presentations of pediatric hearing loss. 2. Select appropriate workup and recognize findings that lead to a decision for cochlear implant. 3. Discuss surgery, plan of care, and the PA/NP role in followup for pediatric CI patients. Fourth Annual ENT for the PA-C | April 24-27, 2014 | Pittsburgh, PA 1 3/27/2014 Why is early detection and treatment of sensorineural hearing loss so important? • Hearing loss is the most frequent birth condition. Fourth Annual ENT for the PA-C | April 24-27, 2014 | Pittsburgh, PA Incidence per 10,000 of Congenital Defects/Diseases 40 30 30 20 12 11 10 6 5 2 1 0 Epidemiology • 1‐3 of 1,000 live births with moderate to severe hearing loss • Approximately 12,000 infants born annually in the U.S. with SNHI – 33 babies / day • 90% of deaf genetic kids / hearing parents Fourth Annual ENT for the PA-C | April 24-27, 2014 | Pittsburgh, PA 2 3/27/2014 Why is early detection and treatment of sensorineural hearing loss so important? • Hearing loss is the most frequent birth condition • Undetected hearing loss has important negative consequences. Fourth Annual ENT for the PA-C | April 24-27, 2014 | Pittsburgh, PA Reading Comprehension Scores of Hearing and Deaf Students 10.0 9.0 8.0 7.0 6.0 Deaf 5.0 Hearing 4.0 3.0 2.0 1.0 Grade Equivalents 8 9 10 11 12 13 14 15 16 17 18 Age in Years Schildroth, A. -
Optical Coherence Tomographic Pattern and Focal Electroretinogram
Eye (2009) 23, 299–303 & 2009 Macmillan Publishers Limited All rights reserved 0950-222X/09 $32.00 www.nature.com/eye Optical coherence A Oishi, H Nakamura, I Tatsumi, M Sasahara, CLINICAL STUDY H Kojima, M Kurimoto, A Otani and N Yoshimura tomographic pattern and focal electroretinogram in patients with retinitis pigmentosa Abstract Keywords: retinitis pigmentosa; electroretinography; optical coherence Purpose The foveal function of patients with tomography; photoreceptor; maculae retinitis pigmentosa (RP) has been estimated by visual acuity (VA) or visual field (VF) tests. In the present study, the potential of optical coherence tomography (OCT) and focal Introduction electroretinogram (fERG) for monitoring macular function in RP patients was Retinitis pigmentosa (RP) is a heterogeneous investigated. group of hereditary diseases that affects Design Cross-sectional observational study. photoreceptors and the retinal pigment Methods A total of 56 eyes of 56 patients with epithelium. As most of the mutations lie in RP underwent ophthalmic examination genes expressed in rod photoreceptors, the including VA, VF, fERG, and OCT. Patients disease typically starts with island scotoma in were morphologically divided into three the midperipheral visual field, and progresses Department of groups by the appearance of photoreceptor to ring-shaped or concentric scotoma. In the Ophthalmology and Visual Sciences, Kyoto University inner/outer segment junction (IS/OS) that very small central visual field left in advanced Graduate School of were depicted with OCT; type 1: no IS/OS cases, some retain good function throughout the Medicine, Kyoto, Japan visible, type 2: IS/OS was visible but the lifetime and others begin to degenerate, length was p2 mm, and type 3: IS/OS 42mm resulting in total blindness. -
Pediatric Anterior Capsulotomy Preferences of Cataract Surgeons
1838 LETTERS cyclooxygenase-2 (COX-2) inhibitors in the treatment The preference of surgeons for a combination of of CME. manual and vitrector capsulorhexis techniques is due Vesta C.K. Chan, MRCS to the elastic nature of the infant anterior capsule David T.L. Liu, FRCS and the high risk for peripheral extension, especially Vincent Y.W. Lee, FRCS in cases of mature cataracts. 2 Philip T.H. Lam, FRCS In 2002, Nischal suggested a 2-incision push-pull Hong Kong, China capsulorhexis for pediatric cataract surgery. Later, Hamada et al.3 introduced their 5-year experience with the 2-incision push-pull technique of anterior REFERENCES and posterior capsulorhexes for pediatric cataract sur- 1. Reis A, Birnbaum F, Hansen LL, Reinhard T. Successful treat- gery. Although it was a great success for capsulorhexis ment of cystoid macular edema with valdecoxib. J Cataract Refract Surg 2007; 33:682–685 in children, the shape and size of the capsulorhexis 2. Flach AJ. The incidence, pathogenesis and treatment of cystoid was not always as predicted by the surgeon. Recently, macular edema following cataract surgery. Trans Am Ophthalmol I described a technique for anterior and posterior con- Soc 1998; 96:557–634; Available at: http://www.pubmedcentral. tinuous curvilinear capsulorhexes in pediatric cataract Z nih.gov/tocrender.fcgi?iid 124633. Accessed July 9, 2007 surgery making 4 small arcuate incisions in the bound- 3. Koutsandrea C, Moschos MM, Brouzas D, et al. Intraocular triam- cinolone acetonide for pseudophakic cystoid macular edema; aries of the intended capsulorhexis and then grasping 4 optical coherence tomography and multifocal electroretinography the center of each incision and pulling it to the center.