1,720,992 research outputs found
Lower medial resection in Convergence Insufficiency
No full textPurpose: Convergence insufficiency can be treated with converging exercises or base-in prism glasses. Surgery for convergence insufficiency generally includes a medial resection. However, this may cause a secondary esotropia at distance. In this study we present the results of resection of only 2-4 mm of the lower part of the medial rectus. Results are combined from two centers: Houston, Texas, USA and Univrsity of L'Aquila, Italy.
Methods: 33 patients who had 10-18XT' at near, 4-10x at distance, had lower part medial resection of 2-4mm. 6/33 had surgery on both medials. 8/33 had lower 2-3mm tenotomies on one or both laterals for XT 6-10 at distance. General guidelines are 2mm for 8-10x', 3mm for 10-12x', and 4mm for 13-16X'. Or perform 2 1/2mm-3mm resection OU for 16-18x'. If scarring was observed on inferior rectus it was removed. If the medial becomes tighter the resection is decreased by 1/2 to 1mm.
Results: Xt' at near decreased to 0-6X'. XT at distance usually decreased by 2-4 prism diopters. A few cases had early esophoria at distance and/or near up to 6 prism diopters that resolved with time. Operate on eye with wider palpebral, since resection narrows fissure by 1/2 mm.
Conclusion: Lower medial resection allows an effective decrease in the excess exotropia at near, without creating esotropia at distance
Prenatal screening for hepatitis B surface antigen. Is universal screening necessary?
No full textPrenatal screening for hepatitis B is now recommended as a universal practice in Canada. This study questions whether that policy should apply outside large urban centres. We studied women delivering babies at the Royal Victoria Hospital in Barrie, Ont. Of 1216 women, results of HBsAg screening were available for 716; only two women, both from a high-risk group, were HBsAg positive. If selective screening is used, physicians must question patients carefully to ensure that women at risk are identified and tested
Postural Dysfuctions and Strabismus: Correlations
Full text linkPurpose: Patient with strabismus may assume a compensatory posture. Posturology treats patients with abnormal head position through the stimulation of foot, ocular and stomatognathic receptors. As an alternation of one or more receptor occurs, the tonic postural system seeks to carer for this problems by adopting compensatory postures (scoliosis, abnormalities of distribution of the podalic load, abnormal head position). The extrinsic eye muscles, the head, neck and tongue muscles arise from the occipital somites: probably this explains the relationship between the ocular misalignment and abnormal posture. The objective of this work is to evaluate the relationships between oculomotor e postural defects.
Methods: N = 47 patients received a comprehensive ophthalmologic and orthoptic examination. They underwent baropodometric and stabilometric examinations.
Results: Our sample group included 37 patients with exodeviation, 17 patients with esodeviation. We observed: flat foot with an incidence rate of 83.33% (25 out of 33) in exotropic subjects; pes cavus with an incidence rate of 16.66% (5 out of 30) in exotropic subjects; flat foot with an incidence rate of 23.52% (4 out of 17) in esotropic subjects; pes cavus with an incidence rate of 76.47% (13 out of 17) in esotropic subjects. Clinical physiatry observation of patients with Eso/Exo deviations prove a considerable turn-out of postural disorders: lumbar scoliosis (76.47%).
Conclusions: In our sample, patients with exodeviation have flat feet (83.33%); the subjects with esodeviation have pes cavus (76.47%). However, there is a widely recognized need for a further extensive study and evaluation of the results obtained regarding binocular vision and posture
Biometric pre-operative evaluation of ocular axial length in patients subjected to corneal transplantation
No full textIn cases of keratoconus and consequent penetrating keratoplasty, the refractive requirements of the patient determine the dimensions of the donor button and the receiving wound size. The pre-operative biometric evaluation of the axial parameters may induce the surgeon to choose an oversized button to obtain the right curvature of the cornea and avoid hypermetropia. In this study we present 20 patients transplanted between 1993 and 1995, 13 female, 7 male, aged between 23 and 45 years. These cases demonstrate the utility of this easy and economic technique
Study of the Orthoptic Assessment in Refractive Eye Surgery
Full text linkPurpose: The aim of our study was to assess the variations in fusion and stereopsis before and after refractive surgery. Methods: We conducted a retrospective study. 140 patients (78 M, 62 F) were selected, aged 20 - 59 years (mean age 36 ± 10 DS). All patients received a comprehensive ophtalmological and orthoptic examination. Surgery was performed using a MEL-80 excimer laser (Carl Zeiss Meditec, Jena, Germany). Results: Fusional convergence amplitudes after refractive eye surgery range from at near 18 - 20 PD in 42 (30%) patients; 25 - 30 PD in 56 (40%) patients; 35 - 40 PD in 42 (30%) patients, at far 20 - 25 PD in 84 (60%) patients; 30 - 40 PD in 56 (40%) patients, fusional divergence at near after refractive eye surgery range from at near 6 - 8 PD in 108 (75.7%) patients; 10 - 12 PD in 52 (37.1%), at far 6 - 8 PD in 126 (90%) patients; 10 - 12 PD in 14 (10%) patients. None of the patients developed any ocular deviations. NCP, on average, decreases from 9.4 ± 1.5 cm to 9.1 ± 0.9 cm after. None of these patients with a normal NCP before surgery developed an abnormal NCP after refractive surgery. Eighteen patients (12.8%) had a stereopsis higher than 60 s of arch before surgical intervention. Of these, in 2 cases (2.8%) stereopsis increased from 200 to 40 s of arch after surgery. In the rest of patients stereopsis remained unchanged. Conclusion: The increase in fusion at near appears to be considerably interesting, whereas there is no worsening of stereopsis. A careful pre-surgery orthoptic evaluation is extremely revelant for a safe refractive surgery, this reducing the risk of complications associated with fusion and stereopsis
MEASUREMENT OF CORNEAL THICKNESS BY ULTRASOUND AFTER PHOTOREFRACTIVE KERATECTOMY IN HIGH MYOPIA
No full textBACKGROUND: Photorefractive keratectomy (PRK) has been used to treat myopia in human eyes since 1988.METHODS: We evaluated corneal ablation depth after excimer laser myopic photorefractive keratectomy with the Summit Technology Excimed UV200LA laser. Preoperative refraction was: mean 9.58 diopters (D) +/- 2.01, (range 6 to 17), We used ultrasound pachometry (1640 m/sec) in 40 eyes of 33 patients. Mean follow-up was of 49.5 weeks (range 16 to 76).RESULTS: The measurement of the corneal thickness showed a reduction of the initial thickness followed by an inconsistent increase caused by wound healing and tissue proliferation.CONCLUSION: The data showed no direct correlation between diopters of refractive correction and the change in corneal thickness
Functional and motor assessment in Patients affected by cognitive decline
No full textPurpose: Cognitive decline is the progressive loss and deterioration of the intellectual functioning triggered by chronic degenerative processes. It is caused by Alzheimer and other degenerative diseases that affect the frontal and temporal lobes of the brain. Furthermore, alterations in cerebral blood vessels could contribute to the cerebrovascular diseases. In this study we evaluated the correlations between patients with visual and cognitive impairment.
Methods: Patients received a comprehensive ophthalmic and orthoptic examination, in particular a reading speed test in words per minute. Our sample included 108 subjects, 50 males and 58 females, age range 65-103 years. 40 patients with mild to moderate cognitive impairment, 28 with vascular dementia, 24 with Alzheimer's disease and 16 with Parkinson's disease.
Results: The reading speed test showed data considerably below the average in 64% of the patients. The Titmus stereo-test revealed absent or little stereopsis in 68% of the subjects. We detected frequent elevation deficiencies, deficits in the medial rectus muscles (43%) and in the inferior oblique muscles (23%). We found a majority of exodeviations and convergence insufficiency, particularly in subjects with Parkinson's disease. In the red filter test, the majority of subjects gave a fusion response at near rather than at distance.
Conclusions: alterations in reading, reduction in visual acuity, deficient stereopsis were observed in those subjects with cognitive impairment. However, visual impairment frequently results from vision problems not adequately treated. This, we highlight the need to define adequate treatment and prevention programmes
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