Schubert, Michael C; Zee, David S
This paper focuses on motor learning within the saccadic and vestibulo-ocular reflex (VOR) oculomotor systems, vital for our understanding how the brain keeps these subsystems calibrated in the presence of disease, trauma, and the changes that invariably accompany normal development and aging. We will concentrate on new information related to multiple time scales of saccade motor learning, adaptation of the VOR during high-velocity impulses, and the role of saccades in VOR adaptation. The role of the cerebellum in both systems is considered. Review of data involving saccade and VOR motor learning. Data supports learning within the saccadic and VOR oculomotor systems is influenced by 1). Multiple time scales, with different rates of both learning and forgetting (seconds, minutes, hours, days, and months). In the case of forgetting, relearning on a similar task may be faster. 2). Pattern of training, learning and forgetting are not similarly achieved. Different contexts require different motor behaviors and rest periods between training sessions can be important for memory consolidation. The central nervous system has the difficult task of determining where blame resides when motor performance is impaired (the credit assignment problem). Saccade and VOR motor learning takes place at multiple levels within the nervous system, from alterations in ion channel and membrane properties on single neurons, to more complex changes in neural circuit behavior and higher-level cognitive processes including prediction.
Lewis, Richard F.; Clendaniel, Richard A.; Zee, David S.; Shelhamer, M. J. (Principal Investigator)
The gain of the vestibulo-ocular reflex (VOR) normally depends on the distance between the subject and the visual target, but it remains uncertain whether vergence angle can be linked to changes in VOR gain through a process of context-dependent adaptation. In this study, we examined this question with an adaptation paradigm that modified the normal relationship between vergence angle and retinal image motion. Subjects were rotated sinusoidally while they viewed an optokinetic (OKN) stimulus through either diverging or converging prisms. In three subjects the diverging prisms were worn while the OKN stimulus moved out of phase with the head, and the converging prisms were worn when the OKN stimulus moved in-phase with the head. The relationship between the vergence angle and OKN stimulus was reversed in the fourth subject. After 2 h of training, the VOR gain at the two vergence angles changed significantly in all of the subjects, evidenced by the two different VOR gains that could be immediately accessed by switching between the diverged and converged conditions. The results demonstrate that subjects can learn to use vergence angle as the contextual cue that retrieves adaptive changes in the angular VOR.
Bock, Otmar; Schmitz, Gerd; Grigorova, Valentina
Previous studies found little or no transfer of adaptation from reactive saccades to arm pointing movements, which suggests that the two motor systems rely on distinct adaptive mechanisms. However, this conclusion is based on experiments about the adaptation of response amplitudes, which is known to follow somewhat different principles than the adaptation of response directions. In the present study, we therefore investigate whether adapting the direction of reactive saccades will transfer to arm movements. We also test transfer in the opposite direction, from the arm to the eyes. Participants executed aimed saccades or arm movements from a central starting point towards visual targets in the participants' frontal plane. Targets were presented in eight possible locations along a circle of 20 cm radius about the starting point; each remained for 200 ms in one position, and was then displaced along the circle by -15 degrees . Participants from group E adapted to these double-stepped targets while executing eye movements, and were then tested for transfer while executing arm movements. The reciprocal design was used in participants from group A. Adaptive change in group A was about 14 degrees , while in group E it was only about 7 degrees . Transfer of adaptation was substantial, and was more pronounced when using the arm (i.e., eye-to-arm transfer in group E) rather than the eyes (i.e., arm-to-eye transfer in group A). Strong aftereffects were yielded in both groups. This pattern of findings implies that the adaptive change observed in our study was mainly based on recalibration rather than on cognitive strategies (strong aftereffects), that eyes and arm had access to a common adaptive mechanism (substantial transfer), and that the arm had better access than the eyes (larger adaptation and transfer when using the arm). When considering this outcome along with the available literature, it appears that arm and eyes may rely sometimes on a common and sometimes on
Ozolinsh, Maris; Muizniece, Kristine; Berzinsh, Janis
Chromostereopsis can be sight and feel in "Virtual Reality" adapters, that induces the appearance of color dependant depth sense and, finally, combines this sense with the source conceived depth scenario. Present studies are devoted to investigation the induced chromastereopsis when using adapted "Virtual Reality" frame together with mobile devices as smartphones. We did observation of composite visual stimuli presented on the high spatial resolution screen of the mobile phone placed inside a portable "Virtual Reality" adapter. Separated for the left and right eyes stimuli consisted of two areas: a) identical for both eyes color chromostereopsis part, and b) additional conventional color neutral random-dot stereopsis part with a stereodisparity based on the horizontal shift of a random-dot segment in images for the left and right eyes, correspondingly. The observer task was to equalize the depth sense for neutral and colored stimuli areas. Such scheme allows to determine actual observed chromostereopsis disparity value versus eye stimuli color difference. At standard observation conditions for adapter with +2D ocular lenses for mobile red-blue stimuli, the perceptual chromostereopsis depth sensitivity on color difference was linearly approximated with a slope SChS ≈ 2.1[arcmin/(Labcolor difference)] for red-blue pairs. Additional to standard application in adapter the tuneable "Varioptic" liquid lens oculars were incorporated, that allowed stimuli eye magnification, vergence and disparity values control electrically.
Partha, Raghavendran; Chauhan, Bharesh K; Ferreira, Zelia; Robinson, Joseph D; Lathrop, Kira; Nischal, Ken K
The underground environment imposes unique demands on life that have led subterranean species to evolve specialized traits, many of which evolved convergently. We studied convergence in evolutionary rate in subterranean mammals in order to associate phenotypic evolution with specific genetic regions. We identified a strong excess of vision- and skin-related genes that changed at accelerated rates in the subterranean environment due to relaxed constraint and adaptive evolution. We also demonstrate that ocular-specific transcriptional enhancers were convergently accelerated, whereas enhancers active outside the eye were not. Furthermore, several uncharacterized genes and regulatory sequences demonstrated convergence and thus constitute novel candidate sequences for congenital ocular disorders. The strong evidence of convergence in these species indicates that evolution in this environment is recurrent and predictable and can be used to gain insights into phenotype–genotype relationships. PMID:29035697
Krishnaveni, V.; Jayaraman, S.; Anitha, L.; Ramadoss, K.
Electroencephalogram (EEG) gives researchers a non-invasive way to record cerebral activity. It is a valuable tool that helps clinicians to diagnose various neurological disorders and brain diseases. Blinking or moving the eyes produces large electrical potential around the eyes known as electrooculogram. It is a non-cortical activity which spreads across the scalp and contaminates the EEG recordings. These contaminating potentials are called ocular artifacts (OAs). Rejecting contaminated trials causes substantial data loss, and restricting eye movements/blinks limits the possible experimental designs and may affect the cognitive processes under investigation. In this paper, a nonlinear time-scale adaptive denoising system based on a wavelet shrinkage scheme has been used for removing OAs from EEG. The time-scale adaptive algorithm is based on Stein's unbiased risk estimate (SURE) and a soft-like thresholding function which searches for optimal thresholds using a gradient based adaptive algorithm is used. Denoising EEG with the proposed algorithm yields better results in terms of ocular artifact reduction and retention of background EEG activity compared to non-adaptive thresholding methods and the JADE algorithm.
Kara H Beaton
Full Text Available Individual differences in sensorimotor adaptability may permit customized training protocols for optimum learning. Here, we sought to forecast individual adaptive capabilities in the vestibulo-ocular reflex (VOR. Subjects performed 400 head-rotation steps (400 trials during a baseline test, followed by 20 min of VOR gain adaptation. All subjects exhibited mean baseline VOR gain of approximately 1.0, variable from trial to trial, and showed desired reductions in gain following adaptation with variation in extent across individuals. The extent to which a given subject adapted was inversely proportional to a measure of the strength and duration of baseline inter-trial correlations (β. β is derived from the decay of the autocorrelation of the sequence of VOR gains, and describes how strongly correlated are past gain values; it thus indicates how much the VOR gain on any given trial is informed by performance on previous trials. To maximize the time that images are stabilized on the retina, the VOR should maintain a gain close to 1.0 that is adjusted predominantly according to the most recent error; hence, it is not surprising that individuals who exhibit smaller β (weaker inter-trial correlations also exhibited the best adaptation. Our finding suggests that the temporal structure of baseline behavioral data contains important information that may aid in forecasting adaptive capacities. This has significant implications for the development of personalized physical therapy protocols for patients, and for other cases when it is necessary to adjust motor programs to maintain movement accuracy in response to pathological and environmental changes.
Fushiki, Hiroaki; Maruyama, Motoyoshi; Shojaku, Hideo
We examined plastic changes in the vestibulo-ocular reflex (VOR) during low-frequency vertical head rotation, a condition under which otolith inputs from the vestibular system are essential for VOR generation. For adaptive conditioning of the vertical VOR, 0.02Hz sinusoidal pitch rotation for one hour about the earth's horizontal axis was synchronized with out-of-phase vertical visual stimulation from a random dot pattern. A vertical VOR was well evoked when the upright animal rotated around the earth-horizontal axis (EHA) at low frequency due to the changing gravity stimulus and dynamic stimulation of the otoliths. After adaptive conditioning, the amplitude of the vertical VOR increased by an average of 32.1%. Our observations showing plasticity in the otolithic contribution to the VOR may provide a new strategy for visual-vestibular mismatch training in patients with otolithic disorders. This low-frequency vertical head rotation protocol also provides a model for investigating the mechanisms underlying the adaptation of VORs mediated by otolith activation. Copyright © 2017 Elsevier B.V. All rights reserved.
Gaddipati, Subhash; Muralidhar, R; Sangwan, Virender S; Mariappan, Indumathi; Vemuganti, Geeta K; Balasubramanian, Dorairajan
To understand the response of oral epithelial cells, transplanted on corneal surface to the ocular cues in vivo. The corneal button obtained after penetrating keratoplasty (PK) of an eye of a patient with total limbal stem cell deficiency (LSCD), previously treated with cultured oral mucosal epithelial transplantation (COMET) was examined by immunohistochemistry for the expression of keratins, p63, p75, PAX6, Ki-67, CD31, and CD34. COMET followed by optical-PK has improved visual acuity to 20/40 and rendered a stable ocular surface. The excised corneal tissue showed the presence of stratified epithelium with vasculatures. The epithelial cells of the corneal button expressed K3, K19, Ki-67, p63, p75 and the cornea-specific PAX6 and K12. This study confirms that the oral cells, transplanted to corneal surface, survive and stably reconstruct the ocular surface. They maintain their stemness at the ectopic site and acquire some of the corneal epithelial-like characters. PMID:23571256
Fernández, Enrique J.; Drexler, Wolfgang
Optical coherence tomography (OCT) enables visualization of the living human retina with unprecedented high axial resolution. The transverse resolution of existing OCT approaches is relatively modest as compared to other retinal imaging techniques. In this context, the use of adaptive optics (AO) to correct for ocular aberrations in combination with OCT has recently been demonstrated to notably increase the transverse resolution of the retinal OCT tomograms. AO is required when imaging is performed through moderate and large pupil sizes. A fundamental difference of OCT as compared to other imaging techniques is the demand of polychromatic light to accomplish high axial resolution. In ophthalmic OCT applications, the performance is therefore also limited by ocular chromatic aberrations. In the current work, the effects of chromatic and monochromatic ocular aberrations on the quality of retinal OCT tomograms, especially concerning transverse resolution, sensitivity and contrast, are theoretically studied and characterized. The repercussion of the chosen spectral bandwidth and pupil size on the final transverse resolution of OCT tomograms is quantitatively examined. It is found that losses in the intensity of OCT images obtained with monochromatic aberration correction can be up to 80 %, using a pupil size of 8 mm diameter in combination with a spectral bandwidth of 120 nm full width at half maximum for AO ultrahigh resolution OCT. The limits to the performance of AO for correction of monochromatic aberrations in OCT are established. The reduction of the detected signal and the resulting transverse resolution caused by chromatic aberration of the human eye is found to be strongly dependent on the employed bandwidth and pupil size. Comparison of theoretical results with experimental findings obtained in living human eyes is also provided.
... Español Eye Health / Eye Health A-Z Ocular Hypertension Sections What Is Ocular Hypertension? Ocular Hypertension Causes ... Hypertension Diagnosis Ocular Hypertension Treatment What Is Ocular Hypertension? Leer en Español: ¿Qué Es la Hipertensión Ocular? ...
... Español Eye Health / Eye Health A-Z Ocular Melanoma Sections What is Ocular Melanoma? Ocular Melanoma Causes ... Melanoma Diagnosis Ocular Melanoma Treatment What is Ocular Melanoma? Leer en Español: ¿Qué Es el Melanoma Ocular? ...
adaptation achieved within the first 16 minutes only. A direction adaptation stimulus would be utilized per Khater , et al. (1990). This method of...the vestibular organs within each inner ear. video-oculography (VOG): a method of collecting eye movement data using video recording techniques. Often...Other methods for measuring the VOR also exist (Halmagyi, 1995; Sharpe & Barber, 1993; Shelhamer, Robinson, & Tan, 1992). Gain and phase are the
Otero, Carles; Vilaseca, Meritxell; Arjona, Montserrat; Martínez-Roda, Joan A; Pujol, Jaume
The aim was to assess the agreement in the measurement of ocular aberrations between a new Adaptive Optics Vision Analyzer (AOVA, Voptica, Murcia, Spain) and a commercial aberrometer (KR-1 W, Topcon, Tokyo, Japan), both based on the Hartmann-Shack technique. One experienced examiner measured 29 healthy right eyes nine consecutive times with the two instruments. The individual Zernike coefficients and the root mean square (RMS) of each order from the second to the fifth order, the higher-order RMS (RMSHOA ), the total RMS (RMSTOT ) and the values of the spherical equivalent (M) and Jackson cross-cylinder (J0 and J45 ) were compared. All aberrations were computed for a 4.0 mm pupil diameter. Bland and Altman analysis showed good agreement between instruments and most of the parameters showed no statistically significant differences. Although the largest mean differences were obtained for the defocus coefficient C(2,0) and the spherical equivalent (M) with a mean difference (and standard deviation) of 0.190 ± 0.099 µm and -0.150 ± 0.188 D, respectively, they were clinically acceptable and significant correlations were found between the AOVA and KR-1 W for the major refractive components such as spherical equivalent (r = 0.995, p < 0.001), J0 (r = 0.964, p < 0.001), J45 (r = 0.901, p < 0.001) and C(4,0) (r = 0.575, p = 0.001). The results suggest good agreement between instruments. Accommodation and misalignment of the measurements may play a role in some of the statistically significant differences that were obtained, specifically for defocus C(2,0), vertical coma C(3,-1) and spherical aberration C(4,0) coefficients; however, these differences were clinically irrelevant. © 2016 Optometry Australia.
Pasadhika, Sirichai; Rosenbaum, James T
Sarcoidosis is one of the leading causes of inflammatory eye disease. Ocular sarcoidosis can involve any part of the eye and its adnexal tissues, and may cause uveitis, episcleritis/scleritis, eyelid abnormalities, conjunctival granuloma, optic neuropathy, lacrimal gland enlargement and orbital inflammation. Glaucoma and cataract can be complications from inflammation itself or adverse effects from therapy. Ophthalmic manifestations can be isolated, or associated with other organ involvement. Patients with ocular sarcoidosis can present with a wide range of clinical presentations and severity. Multi-disciplinary approaches are required to achieve the best treatment outcomes for both ocular and systemic manifestations. PMID:26593141
Gelen Welch Ruiz
Full Text Available Se realizó un estudio descriptivo de tipo retrospectivo longitudinal cuyo universo estuvo constituido por 72 ojos de 72 pacientes con traumatismos oculares mecánicos que fueron hospitalizados en el Hospital Militar Central “Dr. Carlos J. Finlay” desde enero de 1999 hasta enero de 2005. Para el análisis estadístico de la información se utilizó el programa automatizado SPSS versión 11.5 en el cual también se conformó la base de datos y se realizaron los cálculos de acuerdo con el tipo de variable analizada. Se utilizaron medidas de resumen, tendencia central y asociación estadística con un nivel de significación de p A retrospective longitudinal and descriptive study was carried out in 72 eyes from 72 patients with mechanical occular traumas, who had been hospitalized in “Dr. Carlos J. Finlay” Military Hospital from December 1999 to January 2005. For the statistical data analysis, an automated program (SPSS 11.5 version was used to create the database and estimations were made according to the variable types. Summary measures, central tendency measures and statistical association with significance level equal to p < 0.05 were employed. Males prevailed (95.8%, the average age was 30.26 years with a minimum rate of 17 years and maximum rate of 82 years. The most frequent mechanisms of trauma were aggressions (23. 6% and injures from secondary projectiles (13.9%. The anterior segment traumas were more frequent (61, 1% than posterior segment traumas (6.94%. Both segments of the eyeball were affected in 39, 1% of eyes which evinced the worst visual acuity. The most common associated injures were hyphema (54, 2% and vitreous hemorrhage (16.6%. Closed trauma (contusions were more common and most of the eyes had better final visual acuity (45, 2% with vision range of 0.6-1.0 and 26.2% with vision range of 0.59-0.1. On the other hand, eyes affected by open trauma (simple wound, contusion-wound, wound with intraocular foreign body and
... Conditions Frequently Asked Questions Español Condiciones Chinese Conditions Ocular Injury En Español What causes eye injuries ? Injuries ... only the eyelid but the structures that drain tears from the eye. Lacerations of the eyelid or ...
... default.asp. Accessed March 31, 2015. Bron A. Ocular rosacea. http://www.uptodate.com. Accessed March 31, 2015. Riordan-Eva P, et al. Conjunctiva and tears. In: Vaughan & Asbury's General Ophthalmology. 18th ed. New ...
Full Text Available Five cases of ocular rosacea (one male and four females are reported in this paper. Two of the patients were with keratoconjunctivitis sicca, one with conjunctivitis chronica and blepharitis, one with conjunctivitis chronica and meibomitis, and one with reccurent corneal erosions with meibomitis and chordeloum. In four patients ocular symptoms preceded the occurence of skin lesions. The treatment with oral tetracyclines significantly improved the state of ocular rosacea in four patients, while in one case the changes of the anterior eye segment progressed in more severe state of ulcerative keratitis. It is considered that in almost 20% of the patients with rosacea ocular lesions may precede the skin changes, representing a diagnostic problem. Thus, in those cases multidisciplinary approach is suggested. Such approach is particularly important because of the decrease of morbidity and the prevention of the onset of the eye complications such as drastic worsening of visual acuity, i.e., the blindness.
Nagao, S; Kitazawa, H
Adaptation of the horizontal smooth pursuit eye movement was examined using step-ramp moving target paradigms in chronically prepared Macaca fuscata. Monkeys were trained to pursue a small target which moved in the horizontal plane in a 3 degrees step-10 degrees/s ramp or a 0 degrees step-10 degrees/s ramp mode for 300-400 ms. When the target moved from central fixation point in a step-ramp mode, the monkeys usually responded with an initial pursuit eye movement (latency, 100-120 ms) which reached to a nearly constant velocity of 4 degrees/s in 50 100 ms, followed by a 1-3.5 degrees catch-up saccade (latency, 170-230 ms). The catch-up saccade was followed by a 7-8 degrees/s post-saccadic pursuit. The post-saccadic pursuit velocity was measured 40-90 ms after the end of the catch-up saccade. When the target velocity was doubled (20 degrees/s) for 100-200 ms immediately after the onset of the catch-up saccade, the post-saccadic pursuit velocity increased by 40%. When the target velocity was decreased by half (5 degrees/s) immediately after the onset of the catch-up saccade for 150 ms, the post-saccadic pursuit velocity decreased by 30%. These increases or decreases of post-saccadic pursuit were observable within just 50-150 trials. The adaptation of post-saccadic pursuit occurred independent of the position of the target. The amplitude and latency of the catch-up saccade also increased correspondingly when the post-saccadic pursuit velocity was adaptively increased. Adaptation of smooth pursuit did not affect the dynamics of reflex eye movements, including the horizontal vestibulo-ocular reflex (HVOR) gain and phase measured by 0.33 Hz-10 degrees (peak-to-peak) turntable oscillations in darkness. Conversely, adaptation of the HVOR gain induced by a 2 h sustained oscillation of the turntable and screen in reversed direction at 0.33 Hz-10 degrees affected little the velocity of post-saccadic pursuit or the amplitude of the catch-up saccade. These results suggest that
Dai, Chenkai; Fridman, Gene Y.; Chiang, Bryce; Davidovics, Natan; Melvin, Thuy-Anh; Cullen, Kathleen E.; Della Santina, Charles C.
By sensing three-dimensional (3D) head rotation and electrically stimulating the three ampullary branches of a vestibular nerve to encode head angular velocity, a multichannel vestibular prosthesis (MVP) can restore vestibular sensation to individuals disabled by loss of vestibular hair cell function. However, current spread to afferent fibers innervating non-targeted canals and otolith endorgans can distort the vestibular nerve activation pattern, causing misalignment between the perceived and actual axis of head rotation. We hypothesized that over time, central neural mechanisms can adapt to correct this misalignment. To test this, we rendered five chinchillas vestibular-deficient via bilateral gentamicin treatment and unilaterally implanted them with a head mounted MVP. Comparison of 3D angular vestibulo-ocular reflex (aVOR) responses during 2 Hz, 50°/s peak horizontal sinusoidal head rotations in darkness on the first, third and seventh days of continual MVP use revealed that eye responses about the intended axis remained stable (at about 70% of the normal gain) while misalignment improved significantly by the end of one week of prosthetic stimulation. A comparable time course of improvement was also observed for head rotations about the other two semicircular canal axes and at every stimulus frequency examined (0.2–5 Hz). In addition, the extent of disconjugacy between the two eyes progressively improved during the same time window. These results indicate that the central nervous system rapidly adapts to multichannel prosthetic vestibular stimulation to markedly improve 3D aVOR alignment within the first week after activation. Similar adaptive improvements are likely to occur in other species, including humans. PMID:21374081
Sigrid Mueller-Schotte OD, MSc
Full Text Available Intra-ocular straylight can cause decreased visual functioning, and it may cause diminished vision-related quality of life (VRQOL. This cross-sectional population-based study investigates the association between straylight and VRQOL in middle-aged and elderly individuals. Multivariable linear regression analyses were used to assess the association between straylight modeled continuously and cutoff at the recommended fitness-to-drive value, straylight ≥ 1.4 log(s, and VRQOL. The study showed that participants with normal straylight values, straylight ≤ 1.4 log(s, rated their VRQOL slightly better than those with high straylight values (straylight ≥ 1.4 log(s. Furthermore, multivariable regression analysis revealed a borderline statistical significant association ( p = .06 between intra-ocular straylight and self-reported VRQOL in middle-aged and elderly individuals. The association between straylight and self-reported VRQOL was not influenced by the status of the intra-ocular lens (natural vs. artificial intra-ocular lens after cataract extraction or the number of (instrumental activities of daily living that were reported as difficult for the elderly individuals.
Mueller-Schotte, Sigrid; van der Schouw, Yvonne T.; Schuurmans, Marieke J.
Intra-ocular straylight can cause decreased visual functioning, and it may cause diminished vision-related quality of life (VRQOL). This cross-sectional population-based study investigates the association between straylight and VRQOL in middle-aged and elderly individuals. Multivariable linear regression analyses were used to assess the association between straylight modeled continuously and cutoff at the recommended fitness-to-drive value, straylight ≥ 1.4 log(s), and VRQOL. The study showed that participants with normal straylight values, straylight ≤ 1.4 log(s), rated their VRQOL slightly better than those with high straylight values (straylight ≥ 1.4 log(s)). Furthermore, multivariable regression analysis revealed a borderline statistical significant association (p = .06) between intra-ocular straylight and self-reported VRQOL in middle-aged and elderly individuals. The association between straylight and self-reported VRQOL was not influenced by the status of the intra-ocular lens (natural vs. artificial intra-ocular lens after cataract extraction) or the number of (instrumental) activities of daily living that were reported as difficult for the elderly individuals. PMID:28138473
Novack, G D
This review of recent articles on ocular toxicology concentrates on undesirable effects on the eye induced by systemically used xenobiotics. These include color vision deficiencies or visual field deterioration related to antiepileptic drugs, elevated intraocular pressure associated with inhaled corticosteroids, retinal detachments associated with systemic corticosteroids, rifabutin-induced uveitis, cocaine-related retinal hemorrhagic lesions in utero, deferoxamine-related decreases in vision, ocular allergy to bovine-derived collagen, and a large case study of hydroxychloroquine retinotoxicity. Other publications reviewed include a controlled study showing that glucose levels do not seem to alter color vision, a report that intravenous methotrexate can reach clinically meaningful levels in the aqueous humor, and a study showing the effect of systemic pentoxifylline on ocular blood flow and diabetes. With respect to systemic effects of topical ocular medications, there was a case report of apparent systemic exposure to pilocarpine from an Ocusert (Alza Corp., Palo Alto, CA), generalized urticaria after a single application of 1% cyclopentolate, and asthma induced with topical ketorolac. Readers are reminded that no drug achieves ultimate efficacy or ultimate safety. Thus, the decision to employ a given therapy involves a physician's evaluation of its therapeutic index, that is, the ratio between efficacy and toxicity.
Minor, Lloyd B; Lasker, David M
Processes of vestibular compensation mediate recovery of many aspects of vestibular dysfunction following unilateral vestibular injury. The VOR in response to high-frequency, high-acceleration head movements, however, retains an enduring asymmetry. Head movements that are inhibitory with respect to semicircular canals on the intact side lead to a diminished VOR whereas head movements that are excitatory for semicircular canals on the intact side lead to a VOR that returns close to normal. We review our work directed toward understanding the processes of VOR compensation to high-frequency, high-acceleration head movements and the related topic of adaptation to changes in the visual requirements for a compensatory VOR. Our work has shown that the processes of both compensation and adaptation to these stimuli can be described by a mathematical model with inputs from tonic and phasic components. We have further shown that the dynamics of regular afferents have close resemblance to the tonic pathway whereas the dynamics of irregular afferents match those of the phasic pathway.
Merle, H; Gérard, M; Schrage, N
Ocular or thermal burns account for 7.7%-18% of ocular trauma. The majority of victims are young. The burns occur in the setting of accidents at work or in the home, or during a physical attack. Chemical burns by strong acids or bases are responsible for the most serious injuries. Associated with the destruction of limbal stem cells, they present as recurrent epithelial ulcerations, chronic stromal ulcers, deep stromal revascularization, conjunctival overlap, or even corneal perforation. The initial clinical exam is sometimes difficult to perform in the presence of burning symptoms. Nevertheless, it enables the physician to classify the injury, establish a prognosis, and most importantly, guide the therapeutic management. The Roper-Hall modification of the Hughes classification system is the most widely utilized, broken down into stages based on the size of the stromal opacity and the extent of possible limbal ischemia. This classification is now favorably supplemented by those proposed by Dua and Wagoner, which are based on the extent of the limbal stem cell deficiency. The prognosis of the more serious forms of ocular burns has markedly improved over the last decade because of a better understanding of the physiology of the corneal epithelium. Surgical techniques aimed at restoring the destroyed limbal stem cells have altered the prognosis of severe corneal burns. In order to decrease the incidence of burns, prevention, particularly in industry, is essential.
Machado, Anderson Silva; Carneiro, Ana Carolina Aguiar Vasconcelos; Béla, Samantha Ribeiro; Andrade, Gláucia Manzan Queiroz; Vasconcelos-Santos, Daniel Vitor; Januário, José Nélio; Coelho-dos-Reis, Jordana G.; Ferro, Eloisa Amália Vieira; Teixeira-Carvalho, Andréa; Vitor, Ricardo Wagner Almeida; Martins-Filho, Olindo Assis; —UFMG-CTBG, UFMG Congenital Toxoplasmosis Brazilian Group
Toxoplasma gondii is the main infectious cause of human posterior retinochoroiditis, the most frequent clinical manifestation of congenital toxoplasmosis. This investigation was performed after neonatal screening to identify biomarkers of immunity associated with immunopathological features of the disease by flow cytometry. The study included infected infants without NRL and with retinochoroidal lesions (ARL, ACRL, and CRL) as well as noninfected individuals (NI). Our data demonstrated that leukocytosis, with increased monocytes and lymphocytes, was a relevant hematological biomarker of ARL. Immunophenotypic analysis also revealed expansion of CD14+CD16+HLA-DRhigh monocytes and CD56dim cytotoxic NK-cells in ARL. Moreover, augmented TCRγ δ + and CD8+ T-cell counts were apparently good biomarkers of morbidity. Biomarker network analysis revealed that complex and intricated networks underscored the negative correlation of monocytes with NK- and B-cells in NRL. The remarkable lack of connections involving B-cells and a relevant shift of NK-cell connections from B-cells toward T-cells observed in ARL were outstanding. A tightly connected biomarker network was observed in CRL, with relevant connections of NK- and CD8+ T-cells with a broad range of cell subsets. Our findings add novel elements to the current knowledge on the innate and adaptive immune responses in congenital toxoplasmosis. PMID:25328286
Danaides Arencibia González
Full Text Available La cisticercosis establece un grupo de enfermedades zoonóticas parasitarias; cuando se aloja en el ojo y sus anexos producen una cisticercosis ocular y periocular. Constituye una de las causas de uveítis ocular y pérdida importante de la visión. El diagnóstico clínico se realiza mediante la observación directa del parásito, cuando existen opacidades de los medios, el ultrasonido se emplea como medio diagnóstico útil. Los anti helmintos asociados a esteroides forman parte de su terapéutica, sumado al tratamiento definitivo de la extracción del parásito, en este tipo de afección mediante vitrectomía vía pars plana. Se presenta un caso portador de esta condición, se describen las características más importantes del cuadro clínico, diagnóstico, manejo y curso evolutivo-terapéutico.
Hamilton, H L
There are few ocular emergencies that are unique to the pediatric patient. Most ocular emergencies are traumatic in origin, and the prognosis is often determined by the extent of the injury. Some congenital anomalies that may present as ocular emergencies are also discussed. The focus of this article is recognition and initial therapy for the more common pediatric ocular emergencies.
Nemet, Arie Y; Asalee, Leena; Lang, Yaron; Briscoe, Daniel; Assia, Ehud I
Background: One of the most alarming ocular injury trends in recent years has been the proliferation of paintball guns and the proportional increase in the number of ocular eye injuries caused by paintballs...
Chigbu, De Gaulle I
Allergic eye disease is an abnormal immune hypersensitivity response to allergens. It is characterized by IgE-mediated and/or T-lymphocyte-mediated immune hypersensitivity reactions that lead to an immune response, resulting in the clinical manifestations of ocular allergy. This review will focus on immunopathophysiology of the different types of allergic eye disease commonly encountered in the primary care setting. The objective is to provide the clinician with a considerable understanding of the immunopathogenesis of allergic eye disease. The primary focus of this review will be on the antibody- and cell-mediated immune hypersensitivity reactions relevant to allergic eye disease, the different phases of ocular allergic immune response and the histopathological manifestations of these commonly encountered ocular allergies. The basic concepts of immunology with emphasis on adaptive immunity and lymphocyte activation, as well as the components of the immune system that are relevant to ocular allergy will also be reviewed.
Full Text Available São relatados 4 casos de miopatia ocular descendente (MOD com história familial levantada em três gerações. Biópsia musculares e eletromiografia em um caso confirmaram o caráter miogênico da doença. A MOD nada mais seria do que uma forma clínica especial de distrofia muscular, de início tardio.Four cases of the so-called descending ocular myopathy with a family history in three generations are reported. In the first case muscular biopsy and electromyographic studies proved the myogenic nature of the process. Descending ocular myopathy seems to be just a clinical form of muscular distrophy of late onset.
Petersen, E.; Kijlstra, A.; Stanford, M.
Retinal infection with Toxoplasma gondii is the most important cause of posterior uveitis, whereby prevalence and incidence of ocular symptoms after infection depend on socio-economic factors and the circulating parasite genotypes. Ocular toxoplasmosis is more common in South America, Central
Kruger, L P; Acton, J K
Six cases of ocular injury following paintball injuries sustained during war games are described. A CO2-powered rifle shoots a 14 mm plastic-coated paintball at participants. The muzzle velocity of the gun is 250 ft/sec (76 m/sec). Locally manufactured paintballs are harder than the more expensive imported varieties and may account for the severity of our reported injuries. Six patients presented to a retinal specialist with various ocular injuries, predominantly of the posterior pole. All patients were young males. There were no cases of ocular penetration. A variety of retinal pathologies was noted, with three cases requiring surgery; however this did not significantly improve the visual outcome. These cases highlight the severe ocular injuries that may occur from paintball injuries. Recommendations to avoid ocular injury are made.
Tarff, Andreina; Behrens, Ashley
"Red eye" is used as a general term to describe irritated or bloodshot eyes. It is a recognizable sign of an acute/chronic, localized/systemic underlying inflammatory condition. Conjunctival injection is most commonly caused by dryness, allergy, visual fatigue, contact lens overwear, and local infections. In some instances, red eye can represent a true ocular emergency that should be treated by an ophthalmologist. A comprehensive assessment of red eye conditions is required to preserve the patients visual function. Severe ocular pain, significant photophobia, decreased vision, and history of ocular trauma are warning signs demanding immediate ophthalmological consultation. Copyright © 2017 Elsevier Inc. All rights reserved.
Pauca, V. Paúl; Forkin, Michael; Xu, Xiao; Plemmons, Robert; Ross, Arun A.
Ocular recognition is a new area of biometric investigation targeted at overcoming the limitations of iris recognition performance in the presence of non-ideal data. There are several advantages for increasing the area beyond the iris, yet there are also key issues that must be addressed such as size of the ocular region, factors affecting performance, and appropriate corpora to study these factors in isolation. In this paper, we explore and identify some of these issues with the goal of better defining parameters for ocular recognition. An empirical study is performed where iris recognition methods are contrasted with texture and point operators on existing iris and face datasets. The experimental results show a dramatic recognition performance gain when additional features are considered in the presence of poor quality iris data, offering strong evidence for extending interest beyond the iris. The experiments also highlight the need for the direct collection of additional ocular imagery.
... Frequently Asked Questions Español Condiciones Chinese Conditions Pediatric Ocular Trauma What causes eye injuries ? Injuries to the ... only the eyelid but the structures that drain tears from the eye. Lacerations of the eyelid or ...
Ana Carolina Cabreira Vieira
Full Text Available Rosacea is a prevalent chronic cutaneous disorder with variable presentation and severity. Although considered a skin disease, rosacea may evolve the eyes in 58-72% of the patients, causing eyelid and ocular surface inflammation. About one third of the patients develop potentially sight-threatening corneal involvement. Untreated rosacea may cause varying degrees of ocular morbidity. The importance of early diagnosis and adequate treatment cannot be overemphasized. There is not yet a diagnostic test for rosacea. The diagnosis of ocular rosacea relies on observation of clinical features, which can be challenging in up to 90% of patients in whom accompanying roseatic skin changes may be subtle or inexistent. In this review, we describe the pathophysiologic mechanisms proposed in the literature, clinical features, diagnosis and management of ocular rosacea, as well as discuss the need for a diagnostic test for the disease.
Rouhani, Behnaz; Ramasubramanian, Aparna
Pediatric genetic ocular tumors include malignancies like retinoblastoma and phakomatosis like neurofibromatosis, tuberous sclerosis, von Hippel-Lindau syndrome, and nevoid basal cell carcinoma syndrome. It is important to screen for ocular tumors both for visual prognosis and also for systemic implications. The phakomatosis comprise of multitude of benign tumors that are aysmptomatic but their detection can aid in the diagnosis of the syndrome. Retinoblastoma is the most common malignant int...
Dieterich, M; Brandt, T
Recent animal and clinical studies on the vestibulo-ocular reflex deal with a number of physiological and clinical aspects from which three were chosen for this review: (1) the torsional vestibulo-ocular reflex and its disorders; (2) the otolith contribution to the vestibulo-ocular reflex; and (3) neurotransmitters, neuropharmacological aspects, and medical treatment. Disorders of the vestibulo-ocular reflex can be classified according to the three major planes of action, yaw plane, pitch plane, and roll plane, which equate with horizontal nystagmus, upbeat or downbeat nystagmus, and torsional nystagmus, respectively. The particular interest in the torsional vestibulo-ocular reflex arises from new methods for measuring ocular torsion, especially the three-dimensional eye-movement recordings with scleral coils. These methods make it possible to do three-dimensional analysis of the differential effects of horizontal and vertical semicircular canal function and their individual disorders of the torsional vestibulo-ocular reflex. Otolith and semicircular canal inputs converge at the level of the vestibular nuclei to subserve static graviceptive and dynamic torsional and pitch function. The elaboration of the particular sensorial weight of the input from either the otoliths or the semicircular canal is currently a challenge for both physiologists and neurologists. Disorders of otolith function, still absent from the diagnostic repertoire of most neurologists, are increasingly being reported. The most promising developments in therapeutic measures may come from research on vestibular neurotransmitters, their agonists and antagonists. A number of pharmacological agents are effective suppressants of pathological eye movements. However, systematic prospective studies are needed.(ABSTRACT TRUNCATED AT 250 WORDS)
Rouhani, Behnaz; Ramasubramanian, Aparna
Pediatric genetic ocular tumors include malignancies like retinoblastoma and phakomatosis like neurofibromatosis, tuberous sclerosis, von Hippel-Lindau syndrome, and nevoid basal cell carcinoma syndrome. It is important to screen for ocular tumors both for visual prognosis and also for systemic implications. The phakomatosis comprise of multitude of benign tumors that are aysmptomatic but their detection can aid in the diagnosis of the syndrome. Retinoblastoma is the most common malignant intraocular tumor in childhood and with current treatment modalities, the survival is more than 95%. It is transmitted as an autosomal dominant fashion and hence the offsprings of all patients with the germline retinoblastoma need to be screened from birth. This review discusses the various pediatric genetic ocular tumors discussing the clinical manifestation, diagnosis and treatment.
Mariana Mayorquín Ruiz
Full Text Available El ultrasonido ocular es un estudio dependiente del operador. Un buen estudio ecográfico debe tener como base el conocimiento de la anatomía y fisiología normales y de los cambios producidos en diferentes enfermedades, así como los cambios tras una cirugía ocular o trauma. El conocimiento de los fenómenos físicos producidos por el ultrasonido es la base para entender y reconocer la presencia de artefactos en el ultrasonido ocular. Esta revisión tiene como objetivo hacer un recuento de los artefactos que pueden ocasionar confusión al interpretar una imagen ecográfica, así como explicar la base física en la que se basan, reduciendo de esta manera los errores de interpretación y diagnósticos.
Ng, Weng; Chehade, Mark
To describe the presentation and treatment of a Taser penetrating ocular injury. Case report. A 50-year-old man with a Taser injury 1.5 cm below the right lower eyelid margin was admitted to the emergency department of a tertiary hospital. The case report describes the ophthalmic assessment, investigation, treatment, and outcome of the Taser barb penetrating ocular injury. The Taser has a fish hook barb that caused a full-thickness wound adequately large for vitreous to escape when the Taser was removed. Consequently, the scleral wound was repaired and cryopexy was performed. The affected eye made a satisfactory recovery, and the visual acuity was 6/9 with a pinhole 1 week after operation. Any Taser injury around the orbits should raise the suspicion of a penetrating ocular injury. In likely cases, removal of the Taser should be performed in an operating theater under general anesthesia.
Giuliano, Elizabeth A
Feline ocular emergencies include any ophthalmic condition that has rapidly developed or is the result of trauma to the eye or periocular structures. Common feline emergencies include proptosis, lid lacerations, corneal ulcers, and foreign bodies. Complete ophthalmic examination including procurement of the minimal ophthalmic database (Schirmer tear test, fluorescein stain, and intraocular pressure measurement) should be obtained whenever possible to ensure that the complete and correct diagnosis is made. Concern for the patient's vision and ocular comfort should guide the practioner's diagnostic and therapeutic plan. This article reviews some of the more common feline ocular emergencies, including conditions affecting the orbit and globe, adnexa, conjunctiva, and cornea. Feline uveitis, glaucoma, and lenticular diseases are covered more thoroughly elsewhere in this issue.
... When to seek help What is an ocular migraine? Is it a sign of something serious? Answers ... and retinal migraine, which could signal something serious. Migraine aura affecting your vision Ocular migraine sometimes describes ...
Brooks Air Force Base, TX: USAF School of Aerospace Medicine, 1978 6. BROWNELL , A.S., and B.E. STUCK. Ocular and skin hazards from C02 laser...acuity following laser radiation. In: Proceedings of the Human Factors Society. 1980. pp 162-166 9. KELLY , D.H. Photopic contrast sensitivity without
Rasmussen, Peter K; Coupland, Sarah E; Finger, Paul T
IMPORTANCE The clinical features of the follicular subtype of ocular adnexal lymphoma (OAL) have not been previously evaluated in a large cohort. OBJECTIVE To characterize the clinical features of follicular OAL. DESIGN, SETTING, AND PARTICIPANTS We performed a retrospective multicenter study tha...
Kruijt, Bastiaan; Franssen, Luuk; Prick, Liesbeth J. J. M.; van Vliet, Johannes M. J.; van den Berg, Thomas J. T. P.
Albinism is an inherited disorder that affects the melanin biosynthesis pathway, which results in reduced or absent pigment formation. This may lead to increased light transmission through the iris and more reflected light from the fundus. Both these effects contribute to the occurrence of ocular
Full Text Available Leptospiral uveitis is a common entity in tropical countries. Ocular manifestations are noted in the second phase of illness, but these remain under-diagnosed mainly because of the prolonged symptom-free period that separates the systemic manifestations from detection of ocular manifestations.Varying ophthalmic presentations and the intrinsic nature of different types of uveitis to mimic one another also challenge the accuracy of the diagnosis. Of the individual ocular signs, the combination of acute, non-granulomatous, panuveitis, hypopyon, vasculitis, optic disc edema, membranous vitreous opacities and absence of choroiditis or retinitis have high predictive value for the clinical diagnosis of leptospiral uveitis. Geographic location of the patient, occupation, socio-economic status, risk factors related to exposure, past history of fever or jaundice also aid in diagnosis.Steroids are the mainstay of treatment for leptospiral uveitis. Depending upon the severity and anatomical location of inflammatory lesion, topical, peri-ocular and/or systemic steroids are given. The prognosis is generally good, even when the inflammation is severe.
Bhallil, S; Benatiya, I; El Abdouni, O; Mahjoubi, B; Hicham, T
Goldenhar syndrome is a rare congenital anomaly which consists of a triad of an ocular dermoid cyst, preauricular skin tags and vertebral dysplasia. We report two cases of Goldenhar syndrome, diagnosed in a 4-year-old girl and in a 20-year-old young adult. The dermoid cyst is a benign tumour with serious ophthalmologic complications.
Full Text Available Keratoconus is the most common corneal ectatic disorder, the cause of which is largely unknown. Many factors have been implicated, and the ocular allergy is being one of them. The commonly proposed pathogenesis includes the release of inflammatory mediators due to eye rubbing which may alter the corneal collagen and lead to corneal ectasias. The onset of keratoconus is often early in cases associated with allergy and routine corneal topography may detect subtle forms of keratoconus. These cases may require early keratoplasty and are at an increased risk of having acute corneal hydrops. Surgical outcomes are similar to primary keratoconus cases. However, post-operative epithelial breakdown may be a problem in these cases. Control of allergy and eye rubbing is the best measure to prevent corneal ectasias in cases of ocular allergy.
Pedroza-Seres, M; Serna-Ojeda, J C; Flores-Suárez, L F
Sclerodermatomyositis is an overlap syndrome of myositis and scleroderma, with dermatological, muscular and joint involvement, but may also present with ocular manifestations. A 57 year-old woman presented with ophthalmological manifestations, including scleral thinning 360°, and the presence of cells in the anterior and posterior chamber. Oriented physical examination and laboratory studies led to the diagnosis, with the need for systemic treatment. Sclerodermatomyositis is a rare disease. Its diagnosis needs thorough clinical and laboratory studies, and its management should be multidisciplinary when inflammatory ocular manifestations may be present. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.
Kaushik, Sushmita; Pandav, Surinder Singh
Until recently, corneal biomechanical properties could not be measured in vivo. The ocular response analyzer is a new, noninvasive device that analyses corneal biomechanical properties simply and rapidly. The ORA allows cornea compensated IOP measurements and can estimate corneal hysteresis (CH) and corneal resistance factor (CRF). It is designed to improve the accuracy of IOP measurement by using corneal biomechanical data to calculate a biomechanically adjusted estimate of intraocular press...
Full Text Available Microsporidia are eukaryotic, spore forming obligate intracellular parasites, first recognized over 100 years ago. Microsporidia are becoming increasingly recognized as infectious pathogens causing intestinal, ocular, sinus, pulmonary, muscular and renal diseases, in both immunocompetent and immunosuppressed patients. Ocular microsporidiosis, though uncommon, could be isolated or part of systemic infections. It occurs mainly in two forms: keratoconjunctivitis form, mostly seen in immunocompromised individuals; stromal keratitis form seen in immunocomptetant individuals. Recent reports indicate increasing number of cases of ocular microsporidiosis in immunocompetent individuals. The ocular cases present as superficial keratitis in AIDS patients, and these differ in presentation and clinical course from the cases seen in immunocompetent individuals which mainly appear to be as deep stromal keratitis. For most patients with infectious diseases, microbiological isolation and identification techniques offer the most rapid and specific determination of the etiologic agent, however this does not hold true for microsporidia, which are obligate intracellular parasites requiring cell culture systems for growth. Therefore, the diagnosis of microsporidiosis currently depends on morphological demonstration of the organisms themselves, either in scrapings or tissues. Although the diagnosis of microsporidiosis and identification of microsporidia by light microscopy have greatly improved during the last few years, species differentiation by these techniques is usually impossible and electron microscopy may be necessary. Immuno fluorescent-staining techniques have been developed for species differentiation of microsporidia, but the antibodies used in these procedures are available only at research laboratories at present. During the last 10 years, molecular techniques have been developed for the detection and species differentiation of microsporidia.
Kels, Barry D; Grzybowski, Andrzej; Grant-Kels, Jane M
We review the normal anatomy of the human globe, eyelids, and lacrimal system. This contribution explores both the form and function of numerous anatomic features of the human ocular system, which are vital to a comprehensive understanding of the pathophysiology of many oculocutaneous diseases. The review concludes with a reference glossary of selective ophthalmologic terms that are relevant to a thorough understanding of many oculocutaneous disease processes. Copyright © 2015 Elsevier Inc. All rights reserved.
Full Text Available São relatados 4 casos de miopatia ocular descendente (MOD com história familial levantada em três gerações. Biópsia musculares e eletromiografia em um caso confirmaram o caráter miogênico da doença. A MOD nada mais seria do que uma forma clínica especial de distrofia muscular, de início tardio.
Moon, Jeung Hee; Yoon, Dae Young; Choi, Chul Soon; Yoon, Eun Joo; Park, Sang Joon; Seo, Young Lan [Hallym University, Department of Radiology, Kangdong Sacred Heart Hospital, Seoul (Korea); Kim, Byoung Jin [Hallym University, Department of Ophthalmology, Kangdong Sacred Heart Hospital, Seoul (Korea)
Choristoma is a benign tumour defined as normal tissue in an ectopic location. Osseous choristoma, one subtype of this entity, occurring within the orbit has rarely been reported in the world literature. We report a 6-year-old girl with bilateral ocular osseous choristomas who presented with palpable nodules protruding from both upper lids. The radiological and clinical findings are described and previous reports are reviewed. (orig.)
Sramek, Brett; Lisle, Allison; Loy, Timothy
The distinction between ocular sebaceous carcinoma, poorly differentiated ocular squamous cell carcinoma and ocular basal cell carcinoma can be challenging. An appropriate immunohistochemical panel may help to differentiate these lesions. To determine the distribution and use of several immunostains in these specimens, formalin-fixed, paraffin-embedded tissue from several of each was studied using an immunohistochemical technique. Positive staining for cytokeratin (CK)7 was seen in 100% of sebaceous carcinomas, 77.8% of basal cell carcinomas and 67.7% of squamous cell carcinomas. One hundred percent of sebaceous and basal cell carcinomas were positive for cytokeratin CAM 5.2, while only 83.3% of squamous cell carcinomas were positive. Using epithelial membrane antigen (EMA), 100% of squamous cell carcinomas and 80% of sebaceous carcinomas were positive, while basal cell carcinomas were uniformly negative. One hundred percent of basal cell carcinomas and 80% of sebaceous carcinomas were positive for Ber-EP4, while all squamous cell carcinomas were negative. Finally, 77.8%, 20% and 16.7% of basal cell carcinomas, sebaceous carcinomas and squamous cell carcinomas showed immunoreactivity for the androgen receptor. An EMA positive, Ber-EP4 positive immunophenotype supports sebaceous carcinoma, EMA positive, Ber-EP4 negative result supports squamous cell carcinoma and an EMA negative, Ber-EP4 positive result supports basal cell carcinoma.
Flynn, T H
OBJECTIVES: To describe the clinical characteristics of ocular injuries sustained in hurling in the south of Ireland and to investigate reasons for non-use of protective headgear and eye wear. METHODS: Retrospective review of the case notes of 310 patients who attended Cork University Hospital or Waterford Regional Hospital between 1 January 1994 and 31 December 2002 with ocular injuries sustained during a hurling match. A confidential questionnaire on reasons for non-use of protective headgear and eye wear was completed by 130 players. RESULTS: Hurling related eye injuries occurred most commonly in young men. Fifty two patients (17%) required hospital admission, with hyphaema accounting for 71% of admissions. Ten injuries required intraocular surgical INTERVENTION: retinal detachment repair (5); macular hole surgery (1); repair of partial thickness corneal laceration (1); repair of globe perforation (1); enucleation (1); trabeculectomy for post-traumatic glaucoma (1). Fourteen eyes (4.5%) had a final best corrected visual acuity (BCVA) of <6\\/12 and six (2%) had BCVA <3\\/60. In the survey, 63 players (48.5%) reported wearing no protective facemask while playing hurling. Impairment of vision was the most common reason cited for non-use. CONCLUSIONS: Hurling related injury is a significant, and preventable, cause of ocular morbidity in young men in Ireland. The routine use of appropriate protective headgear and faceguards would result in a dramatic reduction in the incidence and severity of these injuries, and should be mandatory.
Nemet, Arie Y; Asalee, Leena; Lang, Yaron; Briscoe, Daniel; Assia, Ehud I
Background: One of the most alarming ocular injury trends in recent years has been the proliferation of paintball guns and the proportional increase in the number of ocular eye injuries caused by paintballs. To describe five cases of paintball eye injuries that resulted in loss of functional vision in four of them. We conducted a retrospective review of the clinical course in five patients with paintball eye injuries treated in the ophthalmology departments of two medical centers. Five young males were evaluated for paintball injuries caused by blunt trauma. There was one case of full-thickness laceration (globe rupture). Four patients required one to five surgical interventions: three of these involved the removal of traumatic cataract including two eyes with significant zonular dehiscence treated by lens capsule conservation using anchoring devices, one retinal surgery and two glaucoma filtration surgeries. However, final visual outcome was not favorable due to irreversible retinal damage. Paintball trauma often results in significant ocular injury and loss of functional vision despite successful surgical intervention. Most injuries occur in under-supervised settings and are easily preventable. Improved safety measures, strict regulation enforcement and appropriate public education could prevent such serious damage.
Kelleher Davis, Robin; Doane, Marshall G; Knop, Erich; Knop, Nadja; Dubielzig, Richard R; Colitz, Carmen M H; Argüeso, Pablo; Sullivan, David A
The importance of tear film integrity to ocular health in terrestrial mammals is well established, however, in marine mammals, the role of the tear film in protection of the ocular surface is not known. In an effort to better understand the function of tears in maintaining health of the marine mammal eye surface, we examined ocular glands of the California sea lion and began to characterize the biochemical nature of the tear film of pinnipeds. Glands dissected from California sea lion eyelids and adnexa were examined for gross morphology, sectioned for microscopic analysis, and stained with hematoxylin and eosin. The tear film was examined using interferometry. Tears were collected from humans and pinnipeds for the analysis of protein and carbohydrate content. The sea lion has sebaceous glands in the lid, but these glands are different in size and orientation compared with typical meibomian glands of terrestrial mammals. Two other accessory ocular glands located dorsotemporally and medially appeared to be identical in morphology, with tubulo-acinar morphology. An outer lipid layer on the ocular surface of the sea lion was not detected using interferometry, consistent with the absence of typical meibomian glands. Similar to human tears, the tears of pinnipeds contain several proteins but the ratio of carbohydrate to protein was greater than that in human tears. Our findings indicate that the ocular gland architecture and biochemical nature of the tear film of pinnipeds have evolved to adapt to the challenges of an aquatic environment. © 2012 American College of Veterinary Ophthalmologists.
Díaz-Doutón, Fernando; Pujol, Jaume; Arjona, Montserrat; Luque, Sergio O
We describe a new wavefront sensor for ocular aberration determination, based on the curvature sensing principle, which adapts the classical system used in astronomy for the living eye's measurements. The actual experimental setup is presented and designed following a process guided by computer simulations to adjust the design parameters for optimal performance. We present results for artificial and real young eyes, compared with the Hartmann-Shack estimations. Both methods show a similar performance for these cases. This system will allow for the measurement of higher order aberrations than the currently used wavefront sensors in situations in which they are supposed to be significant, such as postsurgery eyes.
Katoch Sabita; Devi Anjana; Kulkarni Prajakta
There is a high prevalence of ocular defects in children with developmental disabilities. This study evaluated visual disability in a group of 200 cerebral palsy (CP) patients and found that 68% of the children had significant visual morbidity. These findings emphasize the need for an early ocular examination in patients with CP.
Full Text Available There is a high prevalence of ocular defects in children with developmental disabilities. This study evaluated visual disability in a group of 200 cerebral palsy (CP patients and found that 68% of the children had significant visual morbidity. These findings emphasize the need for an early ocular examination in patients with CP.
Katoch, Sabita; Devi, Anjana; Kulkarni, Prajakta
There is a high prevalence of ocular defects in children with developmental disabilities. This study evaluated visual disability in a group of 200 cerebral palsy (CP) patients and found that 68% of the children had significant visual morbidity. These findings emphasize the need for an early ocular examination in patients with CP.
Full Text Available Yueh-Chang Lee, Cheng-Jen Chiu Department of Ophthalmology, Buddhist Tzu-Chi General Hospital, Hualien, Taiwan, ROC Abstract: This case report describes a female toddler with manifestations of ocular leech infestation. A 2-year-old girl was brought to our outpatient clinic with a complaint of irritable crying after being taken to a stream in Hualien 1 day previous, where she played in the water. The parents noticed that she rubbed her right eye a lot. Upon examination, the girl had good fix and follow in either eye. Slit-lamp examination showed conjunctival injection with a moving dark black–brown foreign body partly attached in the lower conjunctiva. After applying topical anesthetics, the leech, measuring 1 cm in length, was extracted under a microscope. The patient began using topical antibiotic and corticosteroid agents. By 1 week after extraction, the patient had no obvious symptoms or signs, except for a limited subconjunctival hemorrhage, and no corneal/scleral involvement was observed. Keywords: leech, ocular foreign body, conjunctival reaction, pediatric ophthalmology
Jasper, Smitha; Vedula, Satyanarayana S; John, Sheeja S; Horo, Saban; Sepah, Yasir J; Nguyen, Quan Dong
Background Ocular infestation with Toxoplasma gondii, a parasite, may result in inflammation in the retina, choroid, and uvea and consequently lead to complications such as glaucoma, cataract, and posterior synechiae. Objectives The objective of this systematic review was to assess the effects of adjunctive use of corticosteroids for ocular toxoplasmosis. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 9), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE, (January 1950 to October 2012), EMBASE (January 1980 to October 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to October 2012), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We searched the reference lists of included studies for any additional studies not identified by the electronic searches. We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 11 October 2012. Selection criteria We planned to include randomized and quasi-randomized controlled trials. Eligible trials would have enrolled participants of any age who were immunocompetent and were diagnosed with active ocular toxoplasmosis. Included trials would have compared anti-parasitic therapy plus corticosteroids versus anti-parasitic therapy alone, or different doses or times of initiation of corticosteroids. Data collection and analysis Two authors independently screened titles and abstracts retrieved from the electronic searches. We retrieved full-text articles of studies categorized as ‘unsure’ or ‘include’ after review of the abstracts. Two authors independently reviewed each full-text article. Discrepancies were
Tendler, Irwin; Pulitzer, Melissa P; Roggli, Victor; Abramson, David H; Marr, Brian P
To present a novel case of ocular argyrosis mimicking conjunctival melanoma. A 48-year-old man who is a jewelry manufacturer presented with raised pigmented lesions in the inferior fornices of both eyes. Brown-black colored, follicle-like, masses were observed in both fornices. An incisional biopsy confirmed the presence of silver and the diagnosis of ocular argyrosis. Despite its limited negative health effects, ocular argyrosis should be considered in the differential diagnosis of conjunctival pigmented lesions because of the potential for misidentification of neoplastic growth.
Full Text Available The main function of ocular blood flow is to supply sufficient oxygen and nutrients to the eye. Local blood vessels resistance regulates overall blood distribution to the eye and can vary rapidly over time depending on ocular need. Under normal conditions, the relation between blood flow and perfusion pressure in the eye is autoregulated. Basically, autoregulation is a capacity to maintain a relatively constant level of blood flow in the presence of changes in ocular perfusion pressure and varied metabolic demand. In addition, ocular blood flow dysregulation has been demonstrated as an independent risk factor to many ocular diseases. For instance, ocular perfusion pressure plays key role in the progression of retinopathy such as glaucoma and diabetic retinopathy. In this review, different direct and indirect techniques to measure ocular blood flow and the effect of myogenic and neurogenic mechanisms on ocular blood flow are discussed. Moreover, ocular blood flow regulation in ocular disease will be described.
Belser, Jessica A; Rota, Paul A; Tumpey, Terrence M
Respiratory viruses (including adenovirus, influenza virus, respiratory syncytial virus, coronavirus, and rhinovirus) cause a broad spectrum of disease in humans, ranging from mild influenza-like symptoms to acute respiratory failure. While species D adenoviruses and subtype H7 influenza viruses are known to possess an ocular tropism, documented human ocular disease has been reported following infection with all principal respiratory viruses. In this review, we describe the anatomical proximity and cellular receptor distribution between ocular and respiratory tissues. All major respiratory viruses and their association with human ocular disease are discussed. Research utilizing in vitro and in vivo models to study the ability of respiratory viruses to use the eye as a portal of entry as well as a primary site of virus replication is highlighted. Identification of shared receptor-binding preferences, host responses, and laboratory modeling protocols among these viruses provides a needed bridge between clinical and laboratory studies of virus tropism.
Laxman Singh Kaira
Full Text Available An ocular prosthesis is a simulation of of a perfectly normal healthy eye and surrounding tissues. The primary purpose of an ocular prosthesis is to maintain the volume of eye socket and create the illusion of a healthy eye and surrounding tissue. A custom ocular prosthesis is a good option when reconstruction by plastic surgery or the use of Osseo-integrated implants is not possible or not desired. Prosthetic rehabilitation of a patient with missing eye with custom made ocular prosthesis was described. Advantages include improved adaptation, increased mobility of prosthesis, improved facial contours and enhanced esthetics gained from the control of the iris and sclera. An accurate alignment of the artificial eye is one of the major prerequisites for esthetic success of the ocular prosthesis.
Medi Eslani; Alireza Baradaran-Rafii; Asadolah Movahedan; Djalilian, Ali R.
Ocular chemical burns are common and serious ocular emergencies that require immediate and intensive evaluation and care. The victims of such incidents are usually young, and therefore loss of vision and disfigurement could dramatically affect their lives. The clinical course can be divided into immediate, acute, early, and late reparative phases. The degree of limbal, corneal, and conjunctival involvement at the time of injury is critically associated with prognosis. The treatment starts wit...
Dunia Cruz Izquierdo
Full Text Available Se realizó una revisión sobre el trauma ocular y su manejo en pacientes politraumatizados. Entre las causas más frecuentes de trauma ocular se encuentran los accidentes domésticos, laborales, juegos, actividades recreativas y deportivas. Involucran en un alto por ciento a niños y jóvenes, y predomina el sexo masculino en casi todos los trabajos revisados. No solo en Cuba sino en el mundo, el trauma ocular es fuente importante de ceguera unilateral o bilateral. Se presenta un breve compendio de los términos y definiciones actuales que son utilizados para el manejo del trauma ocular, su clasificación y la ventaja que ofrece aplicar el Puntaje del Trauma Ocular, OTS (Ocular Trauma Score, para el pronóstico de la agudeza visual final de acuerdo a los hallazgos clínicos encontrados en la evaluación inicial. Se hace referencia a los pacientes con politrauma y los aspectos a tener en cuenta por el oftalmólogo para tomar conducta cuando estos presentan heridas penetrantes o perforantes y tienen compromiso vital. En estos casos se hace necesaria la colaboración urgente de múltiples especialistas para primero mantener al paciente con vida y luego disminuir las complicaciones que repercuten en su pronóstico visual.A review was made on the ocular trauma and its management in multitrauma patients. The most common causes comprise domestic and occupational accidents, games, recreational and sport activities. It involves more frequently a high percentage of young people, with male prevalence in almost all the reviewed papers. Ocular trauma is an important source of unilateral or bilateral blindness not only in Cuba but worldwide as well. A brief summary of the current terms and definitions used to manage ocular trauma, their classification and the advantage of the Ocular Trauma Score (OTS to know the possible final visual acuity, according to the clinical findings at the emergency room, were presented. Reference was also made to the multitrauma
Myrna Serapião dos Santos
Full Text Available PURPOSE: To establish current definition, classification and staging, and to develop diagnosis and treatment recommendations for ocular allergy, by using Delphi approach. METHODS: Ten Latin American experts on ocular allergy participated in a 4-round Delphi panel approach. Four surveys were constructed and answered by panelists. A two-thirds majority was defined as consensus. Definition, classification, staging and diagnosis and treatment recommendations were the main outcomes. RESULTS: "Ocular allergy" was proposed as the general term to describe ocular allergic diseases. Consensus regarding classification was not reached. Signs and symptoms were considered extremely important for the diagnosis. It was consensus that a staging system should be proposed based on the disease severity. Environmental control, avoidance of allergens and the use of artificial tears were recommended as first line treatment. The secondary treatment should include topical anti-histamines, mast cell stabilizers and multi actions drugs. Topical non-steroidal anti-inflammatory and vasoconstrictors were not recommended. Topical corticosteroids were recommended as third line of treatment for the most severe keratoconjunctivitis. Consensus was not reached regarding the use of systemic corticosteroids or immunosuppressant. Surgical approach and unconventional treatments were not recommended as routine. CONCLUSION: The task of creating guidelines for ocular allergies showed to be very complex. Many controversial topics remain unsolved. A larger consensus including experts from different groups around the world may be needed to further improve the current recommendations for several aspects of ocular allergy.
Thach, A B; Ward, T P; Hollifield, R D; Dugel, P U; Sipperley, J O; Marx, J L; Abrams, D A; Wroblewski, K J; Sonkin, P L; Birdsong, R H; Dunlap, W A
To evaluate the ocular effects of blunt trauma due to injury from a paintball pellet. Noncomparative case series. Thirteen patients who suffered ocular injury from paintballs are described. The patients presented to six different civilian and military emergency departments in tertiary care medical centers. Patients were treated for the ocular injury. Patients were evaluated for initial and final visual acuity. The reason for persistent loss of vision was delineated. There were 12 males and 1 female with an average age of 21 years (range, 12-33 years). Eleven of the 13 had no ocular protection at the time of the ocular injury. On initial examination, nine patients had a hyphema, nine had a vitreous hemorrhage, six had a retinal tear or detachment, three had corneal or corneal-scleral ruptures, and one had traumatic optic neuropathy. The final visual acuity was 20/40 or better in two patients, 20/50 to 20/150 in three patients, and 20/200 or worse in eight patients. Injuries due to paintball pellets can result in severe ocular damage and significant loss of vision. Eyecare professionals should be aware of the risks of this sport and must strongly advise participants to wear adequate protection when involved in this activity.
Full Text Available Inflammation is a complex process that implies the interaction between cells and molecular mediators, which, when not properly “tuned,” can lead to disease. When inflammation affects the eye, it can produce severe disorders affecting the superficial and internal parts of the visual organ. The nucleoside adenosine and nucleotides including adenine mononucleotides like ADP and ATP and dinucleotides such as P1,P4-diadenosine tetraphosphate (Ap4A, and P1,P5-diadenosine pentaphosphate (Ap5A are present in different ocular locations and therefore they may contribute/modulate inflammatory processes. Adenosine receptors, in particular A2A adenosine receptors, present anti-inflammatory action in acute and chronic retinal inflammation. Regarding the A3 receptor, selective agonists like N6-(3-iodobenzyl-5′-N-methylcarboxamidoadenosine (CF101 have been used for the treatment of inflammatory ophthalmic diseases such as dry eye and uveoretinitis. Sideways, diverse stimuli (sensory stimulation, large intraocular pressure increases can produce a release of ATP from ocular sensory innervation or after injury to ocular tissues. Then, ATP will activate purinergic P2 receptors present in sensory nerve endings, the iris, the ciliary body, or other tissues surrounding the anterior chamber of the eye to produce uveitis/endophthalmitis. In summary, adenosine and nucleotides can activate receptors in ocular structures susceptible to suffer from inflammatory processes. This involvement suggests the possible use of purinergic agonists and antagonists as therapeutic targets for ocular inflammation.
Eslani, Medi; Baradaran-Rafii, Alireza; Movahedan, Asadolah; Djalilian, Ali R
Ocular chemical burns are common and serious ocular emergencies that require immediate and intensive evaluation and care. The victims of such incidents are usually young, and therefore loss of vision and disfigurement could dramatically affect their lives. The clinical course can be divided into immediate, acute, early, and late reparative phases. The degree of limbal, corneal, and conjunctival involvement at the time of injury is critically associated with prognosis. The treatment starts with simple but vision saving steps and is continued with complicated surgical procedures later in the course of the disease. The goal of treatment is to restore the normal ocular surface anatomy and function. Limbal stem cell transplantation, amniotic membrane transplantation, and ultimately keratoprosthesis may be indicated depending on the patients' needs.
Full Text Available An intact cerebellum is a prerequisite for optimal ocular motor performance. The cerebellum fine-tunes each of the subtypes of eye movements so they work together to bring and maintain images of objects of interest on the fovea. Here we review the major aspects of the contribution of the cerebellum to ocular motor control. The approach will be based on structural-functional correlation, combining the effects of lesions and the results from physiologic studies, with the emphasis on the cerebellar regions known to be most closely related to ocular motor function: 1 the flocculus/paraflocculus for high-frequency (brief vestibular responses, sustained pursuit eye movements and gaze-holding, 2 the nodulus/ventral uvula for low-frequency (sustained vestibular responses, and 3 the dorsal oculomotor vermis and its target in the posterior portion of the fastigial nucleus (the fastigial oculomotor region for saccades and pursuit initiation.
Full Text Available Ocular chemical burns are common and serious ocular emergencies that require immediate and intensive evaluation and care. The victims of such incidents are usually young, and therefore loss of vision and disfigurement could dramatically affect their lives. The clinical course can be divided into immediate, acute, early, and late reparative phases. The degree of limbal, corneal, and conjunctival involvement at the time of injury is critically associated with prognosis. The treatment starts with simple but vision saving steps and is continued with complicated surgical procedures later in the course of the disease. The goal of treatment is to restore the normal ocular surface anatomy and function. Limbal stem cell transplantation, amniotic membrane transplantation, and ultimately keratoprosthesis may be indicated depending on the patients’ needs.
Alami, Ahmed; Kriet, Mohamed; Reda, Karim; Laktaoui, Abdelkader; Oubaaz, Abdelbaare
Our study aimed to determine the clinical, therapeutic and prognostic features of ocular involvement in patients with Behçet's disease treated in our Department of ophthalmology. We conducted a retrospective data collection from medical records of 20 patients treated at the military hospital in Laayoune. All patients underwent complete ophthalmological examination and fluorescein angiography if necessary. OCT exam was performed in two patients. Ten patients had anterior uveitis, complicated in one case by ocular hypertonia; two patients had intermediate uveitis; eight patients had posterior segment involvement complicated in one case by intravitreal hemorrhage. Behcet's Disease (BD) is an systemic idiopathic inflammatory disease currently classified within primary non-necrotizing vasculitis. Ocular involvement is common and severe in Behçet's disease, with the potential to compromise the visual prognosis. Behcet's disease is common in Morocco. It can compromise patient's visual prognosis making the collaboration between ophthalmologists and internists particularly important.
Morais, Fábio Barreto; Maciel, Ana Lúcia; Arantes, Tiago Eugênio Farias e; Muccioli, Cristina; Allemann, Norma
To evaluate ophthalmic ultrasound findings in the three presentation forms of ocular toxocariasis (peripheral or posterior pole granulomas and chronic endophthalmitis), in patients with confirmed diagnosis of ocular toxocariasis. 11 patients (11 eyes) with clinical and confirmed diagnosis of active ocular toxocariasis, presented positive ELISA test, were analyzed, prospectively, in the study. The patients were submitted to an ocular ultrasound examination (10-MHz transducer, contact technique). In the series of 11 patients, mean age was 7.9 years-old (range from 2 to 17 y), 73% male, referring previous contact with dogs (91%), and with the soil (50%), no referral of appetite perversion. In the analyses of compromised eyes (11 eyes), the ophthalmoscopic examination revealed the following distribution of the 3 forms of ocular toxocariasis: 7 cases (63.6%), posterior pole granuloma; 1 (9.1%), chronic endophthalmitis; 2 (18.2%), peripheral granuloma; and 1 (9.1%), posterior pole granuloma associated with chronic endophthalmitis. Visual acuity impairment: no light perception (3 eyes, 27.3%); hand motion (4 eyes, 36.4%); counting fingers at 10 cm (1 eye, 9.1%); 20/200 (1 eye, 9.1%); 20/70 (1 eye, 9.1%); undefined (1 eye, 9.1%). Serology was positive to Toxocara canis (ELISA test) in 100% of the cases. Ophthalmoscopy was difficult or impossible in 64% of the cases due to the media opacity. Ultrasound findings noted were vitreous membranes with retinal attachment (100%); parietal lesions (granulomas) with high (80%) or medium (20%) reflectivity. The most consistent ultrasound finding in the eye with toxocariasis was a high-reflectivity retinal mass, located in posterior pole or periphery, which may be calcified, and which has as main characteristic the adherence of vitreous membranes. In addition to clinical history, systemic evaluation and serology, the ultrasound can help in the diagnosis of ocular toxocariasis, especially in media opacities.
Full Text Available This paper presents a case of ocular changes in leishmaniasis in a dog brought in for examination because of visible changes in the eyes. An ocular manifestation in leishmaniasis can be bilateral or unilateral. Changes most often occur on the conjunctive and the front segment of the eye, the cornea and iris. From 70 to 80% of dogs diseased with leishmaniasis exhibit frontal uveitis, and dry eye, keratoconjunctivitis sicca, is also a frequent finding. Based on the clinical picture and the positive immunochromatographic rapid test it was established that the dog was diseased with leishmaniasis.
Ness, T; Hengel, H
Vaccinations are very effective measures for prevention of infections but are also associated with a long list of possible side effects. Adverse ocular effects following vaccination have been rarely reported or considered to be related to vaccinations. Conjunctivitis is a frequent sequel of various vaccinations. Oculorespiratory syndrome and serum sickness syndrome are considered to be related to influenza vaccinations. The risk of reactivation or initiation of autoimmune diseases (e. g. uveitis) cannot be excluded but has not yet been proven. Overall the benefit of vaccination outweighs the possible but very low risk of ocular side effects.
Martha G Domínguez Expósito
Full Text Available El carcinoma metastásico del ojo es considerado la neoplasia maligna que más frecuente se encuentra de forma intraocular. Solo cerca del 10 % de las personas que tienen una o más lesiones metastásicas intraoculares son detectadas clínicamente antes de la muerte. A menudo, el carcinoma metastásico ocular es diagnosticado por el oftalmólogo ante la presencia de síntomas oculares. Las lesiones están localizadas con preferencia en coroides. Nos motivo a realizar la presentación de este caso la presencia de lesiones intraoculares múltiples tumorales metastásicos en un paciente cuyo síntoma de presentación fue la disminución de la agudeza visualThe eye metastatic carcinoma is considered the most frequently found intraocular malignant neoplasia. Only 10 % of the persons with one or more metastatic intraocular injuries are clinically detected before death. The metastatic ocular carcinoma is often diagnosed by the ophthalmologist in the presence of ocular symptoms. The injuries are preferably located in the choroid. The appearance of multiple metastatic intraaocular tumoral injuries in a patient whose chief complaint was the reduction of visual acuity motivated us to presente this case
Sonographic measurements of ocular biometry of indigenous Nigerian dogs in Zaria, Nigeria. ... The dogs were adequately restrained physically and the structure of the ocular globe was evaluated at a depth of 4-6 cm. For each dog ... Keywords: Ultrasonography, Baseline Value, Nigerian indigenous Dog, Ocular Biometry ...
Ye, Yufeng; Wang, Jianhua; Xie, Yanan; Jiang, Hong; Zhong, Jianguang; He, Xiaojian; Zhang, Huicheng
This study aimed to determine the feasibility and quality of real-time video transferring in global teleophthalmology using two smartphones during microscopic ocular surgery. An iPhone 4S (Apple) was adapted into a surgical microscope in Hangzhou, Zhejiang, China to capture video during microscopic ocular surgery. An iPhone 5 (Apple), an iPad2 (Apple), and a desktop computer were used as the receptor on the other side of the globe (Miami, FL). A standard resolution test card and the three surgeries of human eyes were captured. During the global video teleconferencing, the real-time video was transferred through Skype from Hangzhou to Miami. A standard resolution test card and the surgery of human eyes were captured. The real-time image resolutions captured and displayed on both phones at different places were measured. Real-time vocal communications concurrent between two parties took place during video conferencing when the ocular surgery was performed in Hangzhou. The video sequences were transferred in real time between the two cities while two parties conversed smoothly without any difficulty. The viewer in Miami clearly visualized the surgical procedure performed in Hangzhou without lagging and distortion. The spatial resolution observed on the video in real time was similar for both phones. The study demonstrated that global video teleophthalmology for microscopic ocular surgery is feasible using two smartphones. The simple, portable, and affordable add-on attachment to the surgical microscope transfers high-quality video for real-time global teleophthalmology.
Galor, Anat; Small, Leslie; Feuer, William; Levitt, Roy C; Sarantopoulos, Konstantinos D; Yosipovitch, Gil
To evaluate associations between sensations of ocular itch and dry eye (DE) symptoms, including ocular pain, and DE signs. A cross-sectional study of 324 patients seen in the Miami Veterans Affairs eye clinic was performed. The evaluation consisted of questionnaires regarding ocular itch, DE symptoms, descriptors of neuropathic-like ocular pain (NOP), and evoked pain sensitivity testing on the forehead and forearm, followed by a comprehensive ocular surface examination including corneal mechanical sensitivity testing. Analyses were performed to examine for differences between those with and without subjective complaints of ocular itch. The mean age was 62 years with 92% being male. Symptoms of DE and NOP were more frequent in patients with moderate-severe ocular itch compared to those with no or mild ocular itch symptoms. With the exception of ocular surface inflammation (abnormal matrix metalloproteinase 9 testing) which was less common in those with moderate-severe ocular itch symptoms, DE signs were not related to ocular itch. Individuals with moderate-severe ocular itch also demonstrated greater sensitivity to evoked pain on the forearm and had higher non-ocular pain, depression, and post-traumatic stress disorders scores, compared to those with no or mild itch symptoms. Subjects with moderate-severe ocular itch symptoms have more severe symptoms of DE, NOP, non-ocular pain and demonstrate abnormal somatosensory testing in the form of increased sensitivity to evoked pain at a site remote from the eye, consistent with generalized hypersensitivity.
Ferreira, T.; Verbist, B.M.; Buchem, M. van; Osch, T. van; Webb, A.
The ocular motor nerves (OMNs) comprise the oculomotor, trochlear and the abducens nerves. According to their course, they are divided into four or five anatomic segments: intra-axial, cisternal, cavernous and intra-orbital and, for the abducens nerve, an additional interdural segment. Magnetic
Yam, Jason C S; Kwok, Alvin K H
The objective of this study is to review the association between ultraviolet (UV) light and ocular diseases. The data are sourced from the literature search of Medline up to Nov 2012, and the extracted data from original articles, review papers, and book chapters were reviewed. There is a strong evidence that ultraviolet radiation (UVR) exposure is associated with the formation of eyelid malignancies [basal cell carcinoma (BCC) and squamous cell carcinoma (SCC)], photokeratitis, climatic droplet keratopathy (CDK), pterygium, and cortical cataract. However, the evidence of the association between UV exposure and development of pinguecula, nuclear and posterior subcapsular cataract, ocular surface squamous neoplasia (OSSN), and ocular melanoma remained limited. There is insufficient evidence to determine whether age-related macular degeneration (AMD) is related to UV exposure. It is now suggested that AMD is probably related to visible radiation especially blue light, rather than UV exposure. From the results, it was concluded that eyelid malignancies (BCC and SCC), photokeratitis, CDK, pterygium, and cortical cataract are strongly associated with UVR exposure. Evidence of the association between UV exposure and development of pinguecula, nuclear and posterior subcapsular cataract, OSSN, and ocular melanoma remained limited. There is insufficient evidence to determine whether AMD is related to UV exposure. Simple behaviural changes, appropriate clothing, wearing hats, and UV blocking spectacles, sunglasses or contact lens are effective measures for UV protection.
Full Text Available Introduction Diagnostic testing of the vestibular system is an essential component of treating patients with balance dysfunction. Until recently, testing methods primarily evaluated the integrity of the horizontal semicircular canal, which is only a portion of the vestibular system. Recent advances in technology have afforded clinicians the ability to assess otolith function through vestibular evoked myogenic potential (VEMP testing. VEMP testing from the inferior extraocular muscles of the eye has been the subject of interest of recent research. Objective To summarize recent developments in ocular VEMP testing. Results Recent studies suggest that the ocular VEMP is produced by otolith afferents in the superior division of the vestibular nerve. The ocular VEMP is a short latency potential, composed of extraocular myogenic responses activated by sound stimulation and registered by surface electromyography via ipsilateral otolithic and contralateral extraocular muscle activation. The inferior oblique muscle is the most superficial of the six extraocular muscles responsible for eye movement. Therefore, measurement of ocular VEMPs can be performed easily by using surface electrodes on the skin below the eyes contralateral to the stimulated side. Conclusion This new variation of the VEMP procedure may supplement conventional testing in difficult to test populations. It may also be possible to use this technique to evaluate previously inaccessible information on the vestibular system.
• A new attention to post-natally acquired infections. Previously, most attention was focused on infection during pregnancy, and the risk of congenital disease, with the feeling that infection in older individuals was benign, without a substantial risk of disease morbidity, such as ocular involvemen...
Oct 8, 2011 ... Malaria is endemic in Nigeria. With the emergence of chloroquine resistance various modes of treatment including parenteral quinine are employed with consequent untoward effects. This article reports two cases of severe ocular toxicity, including mimicry of intracranial space-occupying lesion, from ...
Tse, D T; Mandelbaum, S; Chuck, D A; Nichols, P W; Smith, R E
Lymphomatoid granulomatosis is an angiocentric and angiodestructive lymphoproliferative disorder that involves multiple organs including the lung, skin, kidney and central nervous system. A case of lymphomatoid granulomatosis with ocular involvement is reported herein. Bilateral peripheral retinal vasculitis involving both arterioles and veins, with posterior uveitis, is the prominent clinical finding.
Stürmer, J P E; Kniestedt, C
The ocular pulse amplitude is defined as the difference between diastolic and systolic intraocular pressure. The ocular pulse is generated by the pulsatile ocular blood flow in the choroid. It is dependent on the dynamics of the cardiovascular system, the rigidity of the ocular vessels on one side and the biomechanical properties of the eye on the other side. In addition the influence of outflow facility of the aqueous humor, the level of the intraocular pressure itself and last but not least the rigidity of the sclera on the ocular pulse amplitude is until now not clear. Dynamic contour tonometry (Pascal®) does not only measure intraocular pressure almost independent of corneal thickness and curvature but also allows easy and fast measurement of ocular pulse amplitude on the slit lamp. The ocular pulse amplitude in healthy subjects is between 1.2 and 4 mmHg. If the ocular pulse amplitude is larger than 1.2 mmHg spontaneous pulsations of the central retinal vein are visible on fundoscopy. In patients with ocular hypertension the ocular pulse amplitude is larger than in normal subjects but this is mainly due to higher IOP levels. In patients with manifest open-angle glaucoma the ocular pulse amplitude stays initially within the normal range. In more advanced stages of the disease and especially in patients with ocular perfusion pressure dependent optic neuropathy the ocular pulse amplitude is gradually reduced. Due to the various factors influencing ocular pulse amplitude a direct correlation between reduced ocular pulse amplitude and reduced ocular perfusion pressure has not been established as yet. New approaches investigating the variations of the ocular pressure Fourier spectral analysis are promising, especially when simultaneous analysis of the arterial blood pressure is performed. These techniques may allow a fast and easy discrimination between healthy and glaucomatous patients in the near future. If ocular pulse amplitude exhibits a massive inter-ocular
Kanukollu Venkata Madusudana Rao
Full Text Available BACKGROUND This prospective study aimed to evaluate the incidence of ocular manifestations in head injury and their correlation with the intracranial lesions. MATERIALS AND METHODS A total of 108 consecutive cases of closed head injury admitted in the neurosurgical ward of a tertiary teaching hospital underwent a thorough ophthalmic assessment. Clinical examination, radiological imaging and Glasgow Coma Scale (GCS were applied to grade the severity of injury. RESULTS Total number of 108 patients of head injury were examined of which 38 patients had ocular manifestations (35.18%. Of these, 85.18% were males, 84% of injuries were due to road traffic accidents and 16% were due to fall from a height. The ocular manifestations were as follows- Orbital complications were seen in 6 patients (15.8%. Anterior segment manifestations included black eyes seen in 10 patients (26.3%, subconjunctival haemorrhage in 10.5% of patients (4 patients, corneal involvement in 21% of patients (8 patients and pupillary involvement in 50% of patients (19 patients. Posterior segment manifestations were seen in 26.3% of patients (10 patients and were as follows- Purtscher’s retinopathy in 2 patients and optic atrophy in 5 patients. Cranial nerve palsies were seen in 15 patients (39.47% and supranuclear movement disorders were seen in 3 patients (8%. CONCLUSION Even though, neurosurgeons perform comprehensive clinical examination including eye examination, the main purpose is limited to aid topical diagnosis of neurological lesions. This study emphasises the importance of a detailed eye examination by an ophthalmologist to prevent irreversible visual loss in addition to aiding in the neurological diagnosis. Pupillary involvement, papilloedema and ocular motor paresis pointed to a more severe head injury. This observational prospective study helped us to correlate the severity of head injuries in association with ocular findings in patients admitted in neurosurgical ward
Jerry Y. Niederkorn
Full Text Available Evidence of immune privilege in the eye was recorded almost 140 years ago, yet interest in immune privilege languished for almost a century. However, the past 35 years have witnessed a plethora of research and a rekindled interest in the mechanisms responsible for immune privilege in the anterior chamber of the eye. This research has demonstrated that multiple anatomical, structural, physiological, and immunoregulatory processes contribute to immune privilege and remind us of the enormous complexity of this phenomenon. It is widely accepted that immune privilege is an adaptation for reducing the risk of immune-mediated inflammation in organs such as the eye and brain whose tissues have a limited capacity to regenerate. Recent findings suggest that immune privilege also occurs in sites where stem cells reside and raise the possibility that immune privilege is also designed to prevent the unwitting elimination of stem cells by immune-mediated inflammation at these sites. Uveal melanoma arises within the eye and as such, benefits from ocular immune privilege. A significant body of research reveals an intriguing parallel between the mechanisms that contribute to immune privilege in the eye and those strategies used by uveal melanoma cells to evade immune elimination once they have disseminated from the eye and establish metastatic foci in the liver. Uveal melanoma metastases seem to have plagiarized the blueprints used for ocular immune privilege to create ad hoc immune privileged sites in the liver.
Niederkorn, Jerry Y
Evidence of immune privilege in the eye was recorded almost 140 years ago, yet interest in immune privilege languished for almost a century. However, the past 35 years have witnessed a plethora of research and a rekindled interest in the mechanisms responsible for immune privilege in the anterior chamber of the eye. This research has demonstrated that multiple anatomical, structural, physiological, and immunoregulatory processes contribute to immune privilege and remind us of the enormous complexity of this phenomenon. It is widely accepted that immune privilege is an adaptation for reducing the risk of immune-mediated inflammation in organs such as the eye and brain whose tissues have a limited capacity to regenerate. Recent findings suggest that immune privilege also occurs in sites where stem cells reside and raise the possibility that immune privilege is also designed to prevent the unwitting elimination of stem cells by immune-mediated inflammation at these sites. Uveal melanoma arises within the eye and as such, benefits from ocular immune privilege. A significant body of research reveals an intriguing parallel between the mechanisms that contribute to immune privilege in the eye and those strategies used by uveal melanoma cells to evade immune elimination once they have disseminated from the eye and establish metastatic foci in the liver. Uveal melanoma metastases seem to have "plagiarized" the blueprints used for ocular immune privilege to create "ad hoc immune privileged sites" in the liver.
Highstein, S. M.
Structure-function studies at the systems level are an effective method for understanding the relationship of the central nervous system to behavior. Motor learning or adaptation of the vestibulo-ocular reflex is a clear example wherein this approach has been productive. During a vestibulo-ocular reflex the brain converts a head velocity signal, transduced through the vestibular semicircular canals, into an eye movement command delivered to the extraocular muscles. If the viewed target remains on the fovea of the retina, the reflex is compensatory, and its gain, eye velocity/head velocity, is one. When the image of the viewed object slips across the retina, visual acuity decreases, and the gain of the reflex, which is no longer one, is plastically adapted or adjusted until retinal stability is restored. The anatomic substrate for this plasticity thus involves brain structures in which visual-vestibular interaction can potentially occur, as well as vestibular and visual sensory and oculomotor motor structures. Further, it has been known for many years that removal of the flocculus of the cerebellum permanently precludes further vestibulo-ocular reflex adaptation, demonstrating the involvement of the cerebellum in this behavior. Maekawa and Simpson (J Neurophysiol 1973;36: 649-66) discovered that one visual input to the flocculus involved the accessory optic system and the inferior olive. Ensuing work has demonstrated that the visual signals used to adapt the vestibulo-ocular reflex are transmitted by this accessory optic system to the flocculus and subsequently to brain stem structures involved in vestibulo-ocular reflex plasticity. Presently the inclusive list of anatomic sites involved in vestibulo-ocular reflex circuitry and its adaptive plasticity is small. Our laboratory continues to believe that this behavior should be caused by interactions within this small class of neurons. By studying each class of identified neuron and its interactions with others within
Yañez-Soto, Bernardo; Mannis, Mark J; Schwab, Ivan R; Li, Jennifer Y; Leonard, Brian C; Abbott, Nicholas L; Murphy, Christopher J
Ocular surface disorders, such as dry eye disease, ocular rosacea, and allergic conjunctivitis, are a heterogeneous group of diseases that require an interdisciplinary approach to establish underlying causes and develop effective therapeutic strategies. These diverse disorders share a common thread in that they involve direct changes in ocular surface chemistry as well as the rheological properties of the tear film and topographical attributes of the cellular elements of the ocular surface. Knowledge of these properties is crucial to understand the formation and stability of the preocular tear film. The study of interfacial phenomena of the ocular surface flourished during the 1970s and 1980s, but after a series of lively debates in the literature concerning distinctions between the epithelial and the glandular origin of ocular surface disorders during the 1990s, research into this important topic has declined. In the meantime, new tools and techniques for the characterization and functionalization of biological surfaces have been developed. This review summarizes the available literature regarding the physicochemical attributes of the ocular surface, analyzes the role of interfacial phenomena in the pathobiology of ocular surface disease, identifies critical knowledge gaps concerning interfacial phenomena of the ocular surface, and discusses the opportunities for the exploitation of these phenomena to develop improved therapeutics for the treatment of ocular surface disorders. Copyright © 2014 Elsevier Inc. All rights reserved.
It is estimated that 5-10% of all cutaneous malignancies involve the periocular region and management of periocular skin cancers account for a significant proportion of the oculoplastic surgeon's workload. Epithelial tumours are most frequently encountered, including basal cell carcinoma, squamous cell carcinoma, and sebaceous gland carcinoma, in decreasing order of frequency. Non-epithelial tumours, such as cutaneous melanoma and Merkel cell carcinoma, rarely involve the ocular adnexae. Although non-surgical treatments for periocular malignancies are gaining in popularity, surgery remains the main treatment modality and has as its main aims tumour clearance, restoration of the eyelid function, protection of the ocular surface, and achieving a good cosmetic outcome. The purpose of this article is to review the management of malignant periocular tumours, with particular emphasis on surgical management.
Delair, Emmanuelle; Latkany, Paul; Noble, A Gwendolyn; Rabiah, Peter; McLeod, Rima; Brézin, Antoine
Clinical manifestations of ocular toxoplasmosis are reviewed. Findings of congenital and acute acquired ocular toxoplasmosis include retinal scars, white-appearing lesions in the active phase often associated with vitritis. Complications can include fibrous bands, secondary serous or rhegmatogenous retinal detachments, optic neuritis and neuropathy, cataracts, increased intraocular pressure during active infection, and choroidal neovascular membranes. Recurrences in untreated congenital toxoplasmosis occur in teenage years. Manifestations at birth are less severe, and recurrences are fewer in those who were treated promptly early in the course of their disease in utero and in the first year of life. Severe retinal involvement is common at diagnosis of symptomatic congenital toxoplasmosis in the United States and Brazil. Acute acquired infections also may be complicated by toxoplasmic retinochoroiditis, with recurrences most common close to the time of acquisition. Suppressive treatment can reduce recurrent disease.
Chen, Sandy L; Richard, Christen K; Murthy, Raghu C; Lauer, Andreas K
This report describes the features, treatment and outcome of globe perforation by a Taser dart electrode in a 21-year-old man. The Taser electrode caused mechanical iris, lens and retinal injury and consequent retinal detachment as result of proliferative vitreoretinopathy. The effect of electrical stimulation on ocular tissues is unknown. After the scleral and corneal wounds, traumatic cataract and retinal tear were repaired, the patient regained a visual acuity of 6/18. Nine months later a retinal detachment with proliferative vitreoretinopathy was discovered. The Taser may cause globe perforation and posterior segment injury. Understanding the barbed configuration of the dart electrode is important when extricating this device. Visual recovery is possible despite electric discharge of the Taser and suggests that the mechanism of ocular injury is largely mechanical.
It is estimated that 5–10% of all cutaneous malignancies involve the periocular region and management of periocular skin cancers account for a significant proportion of the oculoplastic surgeon's workload. Epithelial tumours are most frequently encountered, including basal cell carcinoma, squamous cell carcinoma, and sebaceous gland carcinoma, in decreasing order of frequency. Non-epithelial tumours, such as cutaneous melanoma and Merkel cell carcinoma, rarely involve the ocular adnexae. Alth...
Rasmussen, Peter Kristian; Ralfkiaer, E.; Prause, J.U.
Purpose To characterize the clinicopathological features of follicular lymphoma of the ocular adnexal region. Methods Retrospective nation-based study of Danish patients with ocular adnexal follicular lymphoma from January 1st 1980 through December 31st 2009. Results Twenty-four patients...... with ocular adnexal follicular lymphoma were identified. Fourteen (58%) of the patients were females. The median age was 63 years (range: 42–96 years). Eleven (46%) of the patients had primary ocular adnexal lymphoma, seven (29%) had an ocular adnexal lesion in conjunction with a concurrent systemic lymphoma...... and six patients (25%) presented with an ocular adnexal relapse. The most frequently affected sites were the lacrimal gland (38%) and the orbit (33%). Thirteen patients (54%) presented with Ann Arbor stage IE lymphoma, four (17%) had stage IIE, two patients (8%) stage IIIE, and five patients (21%) had...
Sasmal, Nirmal Kumar; Maiti, Prasenjit; Mandal, Radhakrishna; Das, Debabrata; Sarkar, Subhra; Sarkar, Piyali; Biswas, Mukul Chandra; Dey, Asim Kumar; Chatterjee, Sanjay
To evaluate the prevalence of ocular abnormalities among children with cerebral palsy, 140 patients with age between 6 months and 16 years were selected and the overall incidence of ocular abnormalities in this study was 42.1%. Two major ocular abnormalities identified in these cases were strabismus in 36.4%. Myopia was detected in 12.9% children while hypermetropia in 8.6% and astigmatism in 3.6% cases. Non-glaucomatous optic atrophy was present in 10.7% cases and nystagmus in 9.3% cases. Raised intra-ocular pressure was detected in 2.1% cases. Cortical visual impairment was seen in 20.7% children. Ocular abnormalities are frequent manifestations in cerebral palsy patients. Therefore, evaluation of all cerebral palsy cases emphasises the need for a full ophthalmological examination in order to detect ocular problems and to institute necessary therapy of the abnormalities for better livelihood of these physically challenged patients.
Full Text Available Ocular myasthenia gravis is an autoimmune disorder of the neuromuscular junction. Diplopia and ptosis are common symptoms at the onset of ocular myasthenia gravis. It may occur due to the antibodies developed against various drugs. We are reporting a case of ocular myasthenia gravis which was developed in a patient post angiography which may be due to antibody developed against the dye used in angiography.
Vincent, Stephen J; Collins, Michael J; Read, Scott A; Carney, Leo G
Anisometropia represents a unique example of ocular development, where the two eyes of an individual, with an identical genetic background and seemingly subject to identical environmental influences...
Taimi Cárdenas Díaz
Full Text Available En los últimos años se ha producido un extraordinario avance en los conocimientos relacionados con diferentes ramas biomédicas, entre ellas, la biología celular. Esto ha dado un notable impulso a una nueva rama de la medicina denominada medicina regenerativa. Esta nueva disciplina médica se basa fundamentalmente en los nuevos conocimientos sobre las células madre y en su capacidad de convertirse en células de diferentes tejidos. Una de las estructuras que tiene más interés, desde el punto de vista de la medicina regenerativa, es la superficie ocular. Por esto, se ha logrado notables progresos en la reconstrucción de la superficie ocular mediante la aplicación de procederes regenerativos. Los cultivos de células del epitelio corneal humano están siendo utilizados en el tratamiento de la insuficiencia limbar. Esto permite disminuir la incidencia de opacidades tipo Haze tras queratectomía fotorrefractiva, acelerar la curación y evitar la aparición de leucomas en pacientes con defectos epiteliares persistentes e intentar disminuir la incidencia de opacidades corneales en pacientes sometidos a queratectomía fototerapéutica por diferentes distrofias corneales.In the last few years, an extraordinary advance has taken place in the knowledge about several biomedical branches as is the case of cellular biology, which has remarkably encouraged the development of a new medical branch called regenerative medicine. This medical discipline is fundamentally based on the new knowledge on the stem cells and their capacity to become cells for different tissues. One of the most interesting structures for the regenerative medicine is the ocular surface. In the last few years, significant advances have been achieved in the field of the ocular surface reconstruction with regenerative procedures. Some cell cultures of the human corneal epithelium are being used to treat limber insufficiency, to reduce the incidence of haze-type opacities after
Kofoed, Peter Kristian; Munch, Inger Christine; Sander, Birgit
Purpose. To examine retinal function in chronic ocular ischemia using multifocal electroretinography (mfERG). Methods. Thirteen patients with unilateral ocular ischemic syndrome (OIS) underwent assessment of ophthalmic systolic blood pressure by ocular pneumoplethysmography, carotid artery patenc...
Cherecheanu, A Popa; Garhofer, G; Schmidl, D; Werkmeister, R; Schmetterer, L
Glaucoma is a progressive optic neuropathy of unknown origin. It has been hypothesized that a vascular component is involved in glaucoma pathophysiology. This hypothesis has gained support from studies showing that reduced ocular perfusion pressure is a risk factor for the disease. The exact nature of the involvement is, however, still a matter of debate. Based on recent evidence we propose a model including primary and secondary insults in glaucoma. The primary insult appears to happen at the optic nerve head. Increased intraocular pressure and ischemia at the post-laminar optic nerve head affects retinal ganglion cell axons. Modulating factors are the biomechanical properties of the tissues and cerebrospinal fluid pressure. After this primary insult retinal ganglion cells function at a reduced energy level and are sensitive to secondary insults. These secondary insults may happen if ocular perfusion pressure falls below the lower limit of autoregulation or if neurovascular coupling fails. Evidence for both faulty autoregulation and reduced hyperemic response to neuronal stimulation has been provided in glaucoma patients. The mechanisms appear to involve vascular endothelial dysfunction and impaired astrocyte-vessel signaling. A more detailed understanding of these pathways is required to direct neuroprotective strategies via the neurovascular pathway. Copyright © 2012 Elsevier Ltd. All rights reserved.
Full Text Available Metabolic syndrome is a cluster of diseases including central obesity, dyslipidemia, hyperglycemia, and high blood pressure. People with metabolic syndrome have been shown to be at an increased risk of developing cardiovascular disease, beyond the risk associated with individual components of the syndrome. The association of diabetes and hypertension with retinopathy, cataract, and raised intraocular pressure is well known. This review highlights the association of metabolic syndrome, including all its components, with various ocular conditions such as retinopathy, central retinal artery occlusion, cataracts, and raised intraocular pressure.
Ermakov, Igor V.; Sharifzadeh, Mohsen; Gellermann, Warner
The optically transparent nature of the human eye has motivated numerous Raman studies aimed at the non-invasive optical probing of ocular tissue components critical to healthy vision. Investigations include the qualitative and quantitative detection of tissue-specific molecular constituents, compositional changes occurring with development of ocular pathology, and the detection and tracking of ocular drugs and nutritional supplements. Motivated by a better understanding of the molecular mechanisms leading to cataract formation in the aging human lens, a great deal of work has centered on the Raman detection of proteins and water content in the lens. Several protein groups and the hydroxyl response are readily detectable. Changes of protein compositions can be studied in excised noncataractous tissue versus aged tissue preparations as well as in tissue samples with artificially induced cataracts. Most of these studies are carried out in vitro using suitable animal models and conventional Raman techniques. Tissue water content plays an important role in optimum light transmission of the outermost transparent ocular structure, the cornea. Using confocal Raman spectroscopy techniques, it has been possible to non-invasively measure the water to protein ratio as a measure of hydration status and to track drug-induced changes of the hydration levels in the rabbit cornea at various depths. The aqueous humor, normally supplying nutrients to cornea and lens, has an advantageous anterior location for Raman studies. Increasing efforts are pursued to non-invasively detect the presence of glucose and therapeutic concentrations of antibiotic drugs in this medium. In retinal tissue, Raman spectroscopy proves to be an important tool for research into the causes of macular degeneration, the leading cause of irreversible vision disorders and blindness in the elderly. It has been possible to detect the spectral features of advanced glycation and advanced lipooxydation end products in
María Beltrán F
Full Text Available Se presentan tres casos de miasis ocular (dos adultos y un niñoprocedentes de zonas ganaderas de la provincia de Huaura,departamento de Lima,que acudieron al Hospital Regional de Huacho por presentar el ojo rojo,fotofobia, edema palpebral y sensación de cuerpo extraño;se extrajeron larvas adheridas al canto interno del ojo,las cuales se recibieron en el Instituto Nacional de Salud y fueron identificadas como Oestrus ovis .
Ocular trauma is an important cause of unilateral blindness and visual impairment across the world. Most injuries are accidental, work-related injuries in developed countries, while assaults predominate as a cause in developing countries. Trauma may result in various forms of ocular injuries, ranging from minor insult to ...
May 6, 2011 ... Objective: Pregnancy results in a lot of hormonal changes in the body and the eyes are no exception. These ocular changes could be physiologic, pathologic or a modification of a pre-existing condition. The aim of this study was to determine physiologic ocular changes that are associated with pregnancy in ...
Full Text Available Ocular manifestation of granulomatosis with polyangitis. Proptosis is the most common ocular manifestation of granulomatosis with polyangitis. It is due to inflammation of the extraocular muscles or vasculitis of the vas nervosum. It is a poor prognostic sign.
Asseidat, Ibrahim; Kaufman, Lawrence M
We present the first case report of a comprehensive eye examination in a patient with Floating-Harbor syndrome. Ocular findings were limited to partially accommodative, acquired esotropia, and unusual eyelashes. A variety of other ocular features have been previously reported in the nonophthalmic medical literature and are herein reviewed.
Cerebral palsy is commonly associated with ocular abnormalities which often impact on their development and education. There is paucity of studies on this in Nigeria. We decided to study/ determine the prevalence of ocular abnormalities among children with cerebral palsy that attended the neurology clinic of University of ...
Taban, M; Taban, M; Sears, J E
To raise awareness of potential significant ocular damage and visual loss secondary to paintballs in those not wearing ocular protection and to report high incidence of chorioretinitis sclopetaria from paintball contusion. We reviewed cases of eye injury presenting to a single institution from 2000 to 2005. Those cases in which the injury was attributed to paintballs were identified and evaluated to determine ocular findings and visual prognosis. Ocular paintball injuries occurred in eight male subjects and one female subject (nine eyes) with an average age of 16 years (range, 11-26). None had ocular protection at the time of ocular injury. On initial examination, vitreous haemorrhage was present in six eyes (67%), maculopathy, hyphema, cataract, and commotio retinae were each present in four eyes (44%). Two eyes suffered retinal detachment and one eye an optic nerve avulsion. Chorioretinitis sclopetaria occurred in four eyes (44%). The final visual acuity was > or =20/40 in three eyes, 20/50 to 20/150 in two eyes, and paintballs can result in severe ocular damage and visual loss. Increased awareness and need for proper ocular protection should be emphasized by ophthalmologists. Chorioretinitis sclopetaria occurs with a high frequency and its presence should be recognized, as its management is different from retinal tear or detachment.
Ferreira, Teresa [Department of Radiology, Leiden University Medical Center (Netherlands)], E-mail: T.A.Ferreira@lumc.nl; Verbist, Berit [Department of Radiology, Leiden University Medical Center (Netherlands)], E-mail: B.M.Verbist@lumc.nl; Buchem, Mark van [Department of Radiology, Leiden University Medical Center (Netherlands)], E-mail: M.A.van_Buchem@lumc.nl; Osch, Thijs van [C.J. Gorter for High-Field MRI, Department of Radiology, Leiden University Medical Center (Netherlands)], E-mail: M.J.P.van_Osch@lumc.nl; Webb, Andrew [C.J. Gorter for High-Field MRI, Department of Radiology, Leiden University Medical Center (Netherlands)], E-mail: A.Webb@lumc.nl
The ocular motor nerves (OMNs) comprise the oculomotor, trochlear and the abducens nerves. According to their course, they are divided into four or five anatomic segments: intra-axial, cisternal, cavernous and intra-orbital and, for the abducens nerve, an additional interdural segment. Magnetic resonance imaging is the imaging method of choice in the evaluation of the normal and pathologic ocular motor nerves. CT still plays a limited but important role in the evaluation of the intraosseous portions at the skull base and bony foramina. We describe for each segment of these cranial nerves, the normal anatomy, the most appropriate image sequences and planes, their imaging appearance and pathologic conditions. Magnetic resonance imaging with high magnetic fields is a developing and promising technique. We describe our initial experience with a Phillips 7.0 T MRI scanner in the evaluation of the brainstem segments of the OMNs. As imaging becomes more refined, an understanding of the detailed anatomy is increasingly necessary, as the demand on radiology to diagnose smaller lesions also increases.
Full Text Available The ocular surface is exceptionally rich in complexity and functionality. Severe ocular surface disorders/conditions, such as chemical or thermal injuries, Stevens-Johnson syndrome (SJS, ocular cicatricial pemphigoid, neurotrophic keratopathy, chronic limbitis, and severe microbial keratitis cause significant morbidities and even corneal blindness. Hypofunction may be caused by Aniridia, Neurotrophy, Endocrine, Pterygium and Chronic limbitis Approximately 6000 patients are seen in Ocular Surface Clinic every year; almost 80% have some form of dry eyes. About 125 new patients of Stevens Johnson Syndrome are seen in a year of which approximately 25% may benefit from Cultured Epithelial Transplant and 75 new patients of thermal/chemical injury in a year of which almost 80% will benefit from Stem Cell Transplantation. Of the 128 severe vernal keratoconjunctivitis which were seen in the ocular surface clinic, 10% require stem cell transplantation. Nearly 30 new cases of Ocular cicatrical pemphigoid every year are seen and they may need stem cell transplantation. In addition, several patients with persistent epithelial defects may benefit from limbal stem cell transplantation to alleviate, maintain conjunctivalization regression and corneal avascularity limbal deficiency, and restore vision. Even if granted that this statistics is for a single large ophthalmic hospital, for a large country as India with 1.1 billion populations, the number of patients requiring corneal stem cell transplantation is enormous. Stem cells in the palisades of Vogt participate in regeneration and preservation of corneal transparency and avascularity. The diminished regenerative capacity seen in LSCD is characterized by persistent epithelial defects, erosion and ulceration, conjunctivalization and neovascularization, and chronic inflammation. Standard corneal transplantation for restoration of corneal clarity and avascularity is a contraindication in the surgical management
Nakayama, Nanami; Kawamorita, Takushi; Uozato, Hiroshi
We investigated the effects of refractive correction and refractive defocus on the assessment of sensory ocular dominance. In 25 healthy subjects (4 males and 21 females) aged between 20 and 31 years, a quantitative measurement of sensory ocular dominance was performed with refractive correction and the addition of a positive lens on the dominant eye. Sensory ocular dominance was measured with a chart using binocular rivalry targets. The reversal point changed after the addition of a +1.00 D lens on the dominant eye in all subjects. However, sighting ocular dominance and stereopsis did not change after the addition of a positive lens on the dominant eye ( P > 0:05, Wilcoxon test). These results suggest that refractive correction affects sensory ocular dominance, indicating the possible development of a new type of occlusion for amblyopia in the future.
Denise S. Ryan
Full Text Available Purpose. To evaluate the use of ocular imaging to enhance management and diagnosis of war-related anterior segment ocular injuries. Methods. This study was a prospective observational case series from an ongoing IRB-approved combat ocular trauma tracking study. Subjects with anterior segment ocular injury were imaged, when possible, using anterior segment optical coherence tomography (AS-OCT, confocal microscopy (CM, and slit lamp biomicroscopy. Results. Images captured from participants with combat ocular trauma on different systems provided comprehensive and alternate views of anterior segment injury to investigators. Conclusion. In combat-related trauma of the anterior segment, adjunct image acquisition enhances slit lamp examination and enables real time In vivo observation of the cornea facilitating injury characterization, progression, and management.
Cheng, Anny M S; Sheha, Hosam; Tseng, Scheffer C G
To summarize recent advances on ocular Demodex infestation. Demodex infestation is a potential cause of ocular surface inflammation. The pathogenesis of Demodex in eliciting ocular surface inflammation has been further clarified. Cliradex is currently the treatment of choice, it comprises the most active ingredient of tea tree oil, that is terpinen-4-ol, which helps eradicate Demodex mites and reduce ocular surface inflammation. Ocular demodicosis is a common but overlooked eye disease that manifests a number of morbidities. Demodex folliculorum causes chronic anterior blepharitis whereas Demodex brevis causes posterior blepharitis, meibomian gland dysfunction, recurrent chalazia, and refractory keratoconjunctivitis. The lash sampling and microscopic counting method and in-vivo confocal microscopy are key diagnostic methods. Cliradex shows promising potential to reduce Demodex counts with additional antibacterial, antifungal, and anti-inflammatory actions.
Kim, Jae Hoon; Chun, Yeoun Sook
The purpose of this study was to investigate clinical and immunological responses to Demodex on the ocular surface. Thirteen eyes in 10 patients with Demodex blepharitis and chronic ocular surface disorders were included in this study and treated by lid scrubbing with tea tree oil for the eradication of Demodex. We evaluated ocular surface manifestations and Demodex counts, and analyzed IL-1β, IL-5, IL-7, IL-12, IL-13, IL-17, granulocyte colony-stimulating factor, and macrophage inflammatory protein-1β in tear samples before and after the treatment. All patients exhibited ocular surface manifestations including corneal nodular opacity, peripheral corneal vascularization, refractory corneal erosion and infiltration, or chronic conjunctival inflammatory signs before treatment. After treatment, Demodex was nearly eradicated, tear concentrations of IL-1β and IL-17 were significantly reduced and substantial clinical improvement was observed in all patients. In conclusion, we believe that Demodex plays an aggravating role in inflammatory ocular surface disorders. PMID:21935281
Ahmad M. Mansour
Full Text Available Purpose. To discuss an unusual presentation of ocular toxocariasis. Methods. Case report. Results. A 40-year-old woman presented with decreased vision in the left eye with a long history of recurrent red eye from uveitis. Eosinophilia and positive ELISA titers for Toxocara canis favored the diagnosis of ocular toxocariasis. Over 3 months, an anterior scleral mass had a rapid growth raising the possibility of medulloepithelioma, which rarely can mimic uveitic syndromes. Surgical plan changed from local excision to enucleation. Histopathology demonstrated a large homogeneous mass of chronic inflammatory cells with inflammation of the overlying thinned out sclera, medial rectus insertion, and limbal cornea. The triad of peripheral granuloma, eosinophilia, and positive blood serology established the diagnosis of ocular toxocariasis. Conclusions. Ocular toxocariasis can mimic ocular malignancy such as medulloepithelioma in adults and rarely presents as an anterior scleral mass.
Sheybani, Natasha D; Yang, Hu
The eye is a highly complex, yet readily accessible organ within the human body. As such, the eye is an appealing candidate target for a vast array of drug therapies. Despite advances in ocular drug therapy research, the focus on pediatric ocular drug delivery continues to be highly underrepresented due to the limited number of degenerative ocular diseases with childhood onset. In this review, we explore more deeply the reasons underlying the disparity between ocular therapies available for children and for adults by highlighting diseases that most commonly afflict children (with focus on the anterior eye) and existing prognoses, recent developments in ocular drug delivery systems and nanomedicines for children, and barriers to use for pediatric patients.
Full Text Available OBJETIVO: Comparar as correlações dos componentes oculares (comprimento axial, comprimento do segmento anterior, poder médio da córnea, profundidade da câmara vítrea e poder refrativo equivalente com o erro refrativo total do olho portador da menor e da maior ametropia em anisométropes. MÉTODOS: Foi realizado um "survey" analítico conduzido em população de 68 anisométropes de duas ou mais dioptrias atendida no Ambulatório da Clinica Oftalmológica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo Os anisométropes foram submetidos à refração estática objetiva e subjetiva, ceratometria e biometria ultra-sônica. RESULTADOS: Não houve diferença significativa entre os valores dos componentes oculares medidos dos olhos portadores da menor e da maior ametropia. Os olhos portadores da menor ametropia apresentaram as mesmas correlações significantes observadas em olhos emétropes, ou seja, correlação da refração com comprimento do segmento anterior e comprimento axial, e correlação do comprimento axial com poder corneano e profundidade da câmara vítrea. Os olhos portadores da maior ametropia apresentaram correlação significante da refração com o comprimento axial e do comprimento axial com a profundidade da câmara vítrea. Ainda em ambos os olhos observou-se correlação significante do poder do cristalino com a profundidade da câmara anterior. CONCLUSÃO: Os olhos portadores da menor ametropia desenvolveram as correlações mais freqüentemente observadas nos olhos emétropes. Os olhos portadores da maior ametropia não desenvolveram as mesmas correlações dos emétropes.PURPOSE: To asses the correlation between ocular components (axial length, anterior segment length, corneal power, vitreous length and equivalent power of the eye and refractive error in eyes with higher and lower ametropia of subjects with anisometropia. METHODS: An analytical survey was carried out in 68 patients
Prabhakar S Krishnachary
Full Text Available Thelaziasis is an Arthropod-born disease of the eye and adnexa caused by Thelazia callipaeda, a nematode parasite transmitted by drosophilid flies to carnivores and humans. Because of its distribution mainly confined to South Asian countries and Russia, it is commonly known as Oriental Eye worm. It is often under-reported and not been given its due clinical importance. We report first case of human Thelaziasis from Hassan District, Karnataka. Five creamy-white, translucent worms were removed from the conjunctival sac of a 74-year-old male patient. Based on morphological characters, the worms were identified as nematodes belonging to the genus Thelazia and speciation was confirmed by CDC, Atlanta as callipaeda. Rarity of the disease and its ability to cause both extra and intraocular manifestations leading to ocular morbidity is the reason for presenting this case. From the available data, this is the first case report from Karnataka, India.
Süsskind, D; Berneburg, M; Rohrbach, J M
The aim of this study was to evaluate ocular changes in patients with xeroderma pigmentosum (XP) and Cockayne syndrome (CS). Both diseases belong to the progeroid syndromes caused by single gene mutations with premature aging. Both syndromes are very rare autosomal recessive diseases caused by a gene defect leading to deficient DNA repair. 12 patients (4 female, 8 male) with XP between 3 and 67 years old and a 39-year-old female patient with CS were examined. The examination included visual acuity testing, slit lamp biomicroscopy, funduscopy and performance of a Schirmer test. Changes of the lids in the XP group included blepharitis in 7 patients, distichiasis in 2, and madarosis in 3 patients. 8 patients had multiple lentigines solares of the lids. One patient showed scars of the lower lids after excision of a squamous cell carcinoma and a basal cell carcinoma. Conjunctival lesions comprised a tumour of unknown origin of the conjunctiva in 1 patient, teleangiectasia of the conjunctiva in 5 patients, pterygia in 4, and pinguecula in 1 patient. Two patients had an intraepithelial melanosis of the conjunctiva, and one showed conjunctival nevi. Two patients had corneal scars and corneal vascularisation, another a significant conjunctivalisation of the cornea. A Schirmer test was feasible only in 3 patients. Tear production was markedly reduced in all these patients. Break-up time was shortened significantly in 6 patients examined. The patient with the CS showed atrophy of the pupillary rim and a subcapsular cataract. Funduscopically there were pigment epithelial changes. Patients with XP often exhibit ocular changes. Beside the light-dependent degenerative and inflammatory manifestations at the lids, the conjunctiva and the cornea patients with XP also develop malignancies early in life. The majority of patients suffer from dry eye symptoms. © Georg Thieme Verlag KG Stuttgart · New York.
Dalton, Kristine; Guillon, Michel; Naroo, Shehzad A
In golf, the impact of eye-hand dominance on putting performance has long been debated. Eye-hand dominance is thought to impact how golfers judge the alignment of the ball with the target and the club with the ball, as well as how golfers visualize the line of the putt when making decisions about the force needed to hit the ball. Previous studies have all measured ocular dominance in primary gaze only, despite golfers spending a significant amount of their time in a putting stance (bent at the hips, head tilted down). Thus, the purpose of this study was to assess ocular dominance in both primary gaze (aligning the ball with the target) and putting gaze (addressing the ball and aligning the club). This study investigated measuring pointing ocular dominance in both primary and putting gaze positions on 31 golfers (14 amateur, 7 club professionals, and 10 top professionals). All players were right-handed golfers, although one reported having no hand dominance and one reported being strongly left hand dominant. The results showed that (1) primary and putting gaze ocular dominances are not equal, nor are they predictive of each other; (2) the magnitude of putting ocular dominance is significantly less than the magnitude of primary gaze ocular dominance; (3) ocular dominance is not correlated with handedness in either primary or putting gaze; and (4) eye-hand dominance is not associated with increased putting skill, although ocular dominance may be associated with increased putting success. It is important that coaches assess golfers' ocular dominance in both primary and putting gaze positions to ensure they have the most accurate information upon which to base their vision strategy decisions.
Barsotti, Giovanni; Sgorbini, Micaela; Marmorini, Paola; Corazza, Michele
To determine the prevalence and describe ocular abnormalities in healthy Standardbred foals within 48 h of birth. One hundred and two neonatal foals. All foals had an unassisted delivery. On the basis of physical examination and the results of hematological and biochemical parameters, all foals were unaffected by systemic diseases. A complete ophthalmic examination was performed within 48 h of birth. Foals with ocular hemorrhages were re-examined weekly until the abnormalities were resolved. 65/102 (63.7%) foals did not show ocular abnormalities, while in 37/102 (36.3%) cases, ocular abnormalities were present. Retinal and subconjunctival hemorrhages were recorded in 19/102 (18.6%), and in 13/102 (12.7%), respectively. In 4/102 (3.9%) animals, an entropion of the lower eyelid was present. Only one foal (1%) showed a congenital nuclear unilateral cataract. No other ocular abnormalities were detected. However, all foals showed various degrees of remnants of hyaloid system. One week after the first ocular examination, retinal hemorrhages had resolved in 100% of the eyes, whereas subconjunctival hemorrhages had disappeared in all eyes by the second week following the first examination. The acquired ocular lesions observed with relatively high frequency in the examined healthy Standardbred foals were ocular hemorrhages, which always showed a good outcome. Although these abnormalities were present at birth, they were not considered strictly congenital but likely acquired during parturition. Instead, congenital ocular abnormalities were rarely diagnosed, and the entropion of the lower eyelid was the most common disease in the breed. © 2012 American College of Veterinary Ophthalmologists.
Full Text Available Chemical burns represent potentially blinding ocular injuries and constitute a true ocular emergency requiring immediate assessment and initiation of treatment. The majority of victims are young and exposure occurs at home, work place and in association with criminal assaults. Alkali injuries occur more frequently than acid injuries. Chemical injuries of the eye produce extensive damage to the ocular surface epithelium, cornea, anterior segment and limbal stem cells resulting in permanent unilateral or bilateral visual impairment. Emergency management if appropriate may be single most important factor in determining visual outcome. This article reviews the emergency management and newer techniques to improve the prognosis of patients with chemical injuries.
Laine García Ferrer
Full Text Available El trauma ocular es una causa importante de morbilidad oftalmológica en el mundo con implicaciones socioeconómicas importantes para el paciente y sus familiares. Ocurre generalmente en adultos jóvenes, con una buena agudeza visual al inicio del evento traumático, la cual se verá comprometida según la severidad del trauma, las estructuras oculares que afecte y las complicaciones que puedan aparecer. Presentamos dos pacientes con rotura escleral posterior secundario a trauma ocular a globo abierto contuso. Se describe el manejo personalizado el seguimiento en cada caso y sus resultados visuales.
Full Text Available La toxocariosis es una geohelmintiosis producida por la ingestión de
huevos de Toxocara canis y T. catis, cuyos hospederos definitivos son el perro y el gato. En el humano las larvas producen el Síndrome de Migración Larvaria Visceral y Ocular; en este último produce una enfermedad grave que puede semejar un retinoblastoma (1,2. Los niños son más susceptibles a adquirir esta infección (3. Nuestro objetivo es determinar la frecuencia de toxocariosis ocular en menores de edad con sintomatología ocular.
Na, Kyung-Sun; Yoo, Young-Sik; Hwang, Kyu-Yeon; Mok, Jee-Won; Joo, Choun-Ki
To evaluate the diagnostic value of tear osmolarity and several ocular surface parameters in screening for ocular surface alterations in ocular graft-vs-host disease (GVHD) patients. Case-control study. Sixty-three patients with ocular GVHD and 74 healthy participants were screened for ocular surface changes using the Ocular Surface Disease Index (OSDI), tear osmolarity, Schirmer test, tear break-up time (TBUT), and fluorescein corneal staining. The severity of ocular GVHD was diagnosed according to the National Institutes of Health (NIH) grading system. The diagnostic sensitivity and specificity and cutoff values were determined for each ocular parameter using a receiver operating characteristic (ROC) curve and area under the curve (AUC) analysis. Significance was defined at P tear osmolarity, corneal staining score, and OSDI score gradually increased as the severity of ocular GVHD increased, and Schirmer value gradually decreased as the GVHD grade increased in severity. The Schirmer test showed greatest diagnostic sensitivity and specificity for ocular GVHD (92.1% sensitivity, 85.7% specificity, cutoff = 9 mm), followed by the TBUT (87.3% sensitivity, 75.0% specificity, cutoff = 6 s), tear osmolarity (98.4% sensitivity, 60.7% specificity, cutoff = 311 mOsm/L), corneal staining score (66.7% sensitivity, 82.1% specificity, cutoff = 2), and OSDI score (77.8% sensitivity, 66.1% specificity, cutoff = 20.8). Multiple diagnostic modalities should be used to detect ocular surface changes in GVHD patients. The severity of ocular GVHD can be effectively monitored using tear osmolarity; however, additional studies are required. Copyright © 2015 Elsevier Inc. All rights reserved.
Zheleznyak, Len; Alarcon, Aixa; Dieter, Kevin C; Tadin, Duje; Yoon, Geunyoung
Monovision presbyopia interventions exploit the binocular nature of the visual system by independently manipulating the optical properties of the two eyes. It is unclear, however, how individual variations in ocular dominance affect visual function in monovision corrections. Here, we examined the impact of sensory ocular dominance on visual performance in both traditional and modified monovision presbyopic corrections. We recently developed a binocular adaptive optics vision simulator to correct subjects' native aberrations and induce either modified monovision (1.5 D anisometropia, spherical aberration of +0.1 and -0.4 μm in distance and near eyes, respectively, over 4 mm pupils) or traditional monovision (1.5 D anisometropia). To quantify both the sign and the degree of ocular dominance, we utilized binocular rivalry to estimate stimulus contrast ratios that yield balanced dominance durations for the two eyes. Through-focus visual acuity and contrast sensitivity were measured under two conditions: (a) assigning dominant and nondominant eye to distance and near, respectively, and (b) vice versa. The results revealed that through-focus visual acuity was unaffected by ocular dominance. Contrast sensitivity, however, was significantly improved when the dominant eye coincided with superior optical quality. We hypothesize that a potential mechanism behind this observation is an interaction between ocular dominance and binocular contrast summation, and thus, assignment of the dominant eye to distance or near may be an important factor to optimize contrast threshold performance at different object distances in both modified and traditional monovision.
Victoria J. Vieira-Potter
Full Text Available Diabetes mellitus (DM is a metabolic disease defined by elevated blood glucose (BG. DM is a global epidemic and the prevalence is anticipated to continue to increase. The ocular complications of DM negatively impact the quality of life and carry an extremely high economic burden. While systemic control of BG can slow the ocular complications they cannot stop them, especially if clinical symptoms are already present. With the advances in biodegradable polymers, implantable ocular devices can slowly release medication to stop, and in some cases reverse, diabetic complications in the eye. In this review we discuss the ocular complications associated with DM, the treatments available with a focus on localized treatments, and what promising treatments are on the horizon.
Corbu, Cătălina; Creţu, Carmen; Predoi, Daniela; Tatu, Mihaela
The paper reports three clinical cases which have in common two elements: ocular toxoplasmosis and consecutive complicative cataract, the method of treatment, the evolution and the recovery visual acuity.
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Se presenta el caso de un paciente con un cisticerco retiniano, tratado sin éxito con praziquantel, quien a los cinco meses del tratamiento presentó fibrosis y desprendimiento de la retina. Se realizó intervención quirúrgica y se encontró el cisticerco vivo. Desde antes de la operación el paciente había perdido la visión por el ojo afectado. Se hace una revisión sobre oftalmocisticercosis y se recomienda tratamiento quirúrgico oportuno y no usar los antihelmínticos con efecto sobre los cisticercos, como son praziquantel y albendazol.
One case of ocular cysticercosis with retinal involvement, in which praziquantel treatment was ineffective, is presented. Five months after the medical treatment the patient presented with retinal detachment and fibrosis, loss of vision through the affected eye and at that time the parasite was observed alive. Surgical intervention was performed and the recovered cysticercus showed viability. A review on ophtalmocysticercosis is presented and recommendations are made to treat these cases by early surgery without prior administration of anticysticercus drugs such as praziquantel or albendazole.
Garcia, Maria D; Pulido, Jose S; Coon, Elizabeth A; Chen, John J
The aim of this paper is to gain better understanding of the ocular manifestations of multiple system atrophy (MSA), a neurodegenerative disorder rarely studied in terms of its ophthalmologic features. We performed a retrospective case series (1/1/05-12/31/14) to search for patients seen at Mayo Clinic, Rochester, MN, who had mention of MSA in the medical record and an eye examination, which yielded 285 cases. Of the 285, we identified 39 cases of true MSA. Each of these 39 patients was further reviewed for ocular abnormalities potentially related to MSA. Ocular findings potentially attributable to MSA were found in 64% of patients. Most common were dry eye (N = 14), conjugate eye movement abnormalities (N = 13), and ocular misalignment (N = 7). One patient had dry eye and monocular diplopia from trichiasis due to cicatricial pemphigoid, one had bilateral optic atrophy, and one had Adie's tonic pupil. Conjugate eye movement abnormalities (33%) and ocular misalignment (18%) were more common in patients with MSA-C. Patients with ocular findings, excluding dry eye, had a significantly shorter lifespan from time of initial neurologic symptoms to death. Our study confirms conjugate eye movement abnormalities and misalignment are common ocular findings in patients with MSA. Bilateral optic atrophy and cicatricial pemphigoid are possibly attributable to the disease. Ocular manifestations in MSA predict a poor prognosis as these patients have a significantly shorter lifespan. Therefore, we recommend patients with MSA have a comprehensive neuro-ophthalmologic exam at time of diagnosis, and thereafter, to screen for eye findings that may indicate a shorter lifespan. Copyright © 2017 Elsevier Ltd. All rights reserved.
Siddesh Kumar Chintal
Full Text Available The disfigurement associated with the loss of an eye can cause significant physical and emotional problems. Various treatment modalities are available, one of which is implants. Although implant has a superior outcome, it may not be advisable in all patients due to economic factors. The present article describes the prosthetic management of an ocular defect with a custom-made ocular prosthesis.
Bora, Nalini S.; Jha, Purushottam; Bora, Puran S.
Functionally active complement system and complement regulatory proteins are present in the normal human and rodent eye. Complement activation and its regulation by ocular complement regulatory proteins contribute to the pathology of various ocular diseases including keratitis, uveitis and age-related macular degeneration. Furthermore, a strong relationship between age-related macular degeneration and polymorphism in the genes of certain complement components/complement regulatory proteins is...
Gary N Holland
Full Text Available The influence of patient age on various features of ocular toxoplasmosis has been a subject of study for many years. The age at which Toxoplasma gondii infection occurs in different populations is related to socioeconomic factors and studies suggest that ocular toxoplasmosis is a more severe disease at the extremes of age. The prevalence of ocular involvement is markedly different between individuals with congenital and those with post-natally acquired infections. Even among those with post-natally acquired infections, age influences the risk and timing of ocular involvement. The severity of toxoplasmic retinochoroiditis (in terms of lesion size, location and associated inflammation is also affected by patient age at the time of initial infection or recurrence. The risk of recurrent toxoplasmic retinochoroiditis is influenced by age at the time of initial infection and age at most recent episode of active disease. Understanding of relationships between ocular toxoplasmosis and patient age is incomplete; evidence has often been indirect and in some cases conflicting. The influence of patient age on ocular toxoplasmosis should be studied in a systematic manner to provide a better understanding of disease mechanisms and to provide clinical information that can used to establish better strategies for disease treatment and prevention.
Scherrer, Nicole M; Lassaline, Mary; Engiles, Julie
To determine the characteristics of and prognosis for ocular and periocular hemangiosarcoma in horses. Six horses treated for ocular or periocular hemangiosarcoma. A retrospective review of medical records from 2007 to 2015 was performed to identify horses with a histologic diagnosis of ocular or periocular hemangiosarcoma. Signalment (age, sex, breed), duration of clinical signs, prior treatment, tumor size and location, medical and surgical treatment including postoperative chemotherapy, follow-up time, and outcome were obtained from medical records. Histopathology was reviewed by a board-certified pathologist. In six horses diagnosed with ocular or periocular hemangiosarcoma, no breed, age, or sex was overrepresented. Sites included the temporal limbus (3), third eyelid (2), and uvea (1). With the exception of one horse with uveal hemangiosarcoma, 5/6 horses had lightly pigmented periocular haircoat. Histologic features of ocular hemangiosarcoma in 6/6 cases included high cellularity, nuclear pleomorphism, and inflammation with a mitotic index ranging from 0 to 8 mitoses per 10 consecutive 400× fields. Five of six tumors displayed solar elastosis, indicating ultraviolet light-induced damage to sub-epithelial collagen. Treatment included surgical excision in all cases and was not associated with recurrence in 4/6. Three cases that received ancillary treatment with topical mitomycin C had no postoperative recurrence. Two cases with postexcisional recurrence had histologic evidence of incomplete excision. Complete surgical excision may be associated with resolution of periocular and ocular hemangiosarcoma in horses. Etiopathogenesis may include exposure to ultraviolet light. © 2017 American College of Veterinary Ophthalmologists.
Full Text Available This review article aimed to evaluate ocular biometric changes after trabeculectomy. The PubMed database was searched using the keywords “axial length” (AL, “anterior chamber depth” (ACD, “corneal astigmatism,” “corneal topography” and “trabeculectomy.” The extracted studies were categorized based on the evaluated parameters and the biometry method (contact and non-contact. Comparable studies with respect to their sample size were combined for statistical analysis. Twenty-five studies including 690 individuals which met the inclusion criteria were selected. After trabeculectomy, a significant and persistent AL reduction, with a range of 0.1-0.19 and 0.1-0.9 mm measured with contact and non-contact methods, respectively, was observed. With respect to topographic changes, 0.38-1.4 diopters (D with-the-rule (WTR astigmatism was induced postoperatively. All studies revealed ACD reduction immediately after surgery, which gradually deepened and approximated its preoperative levels on day 14. ACD reduction was not significant after that period in the majority of cases. In conclusion, changes in ACD is of small amount and of short period, thus it can be ignored; however, reported changes in AL and keratometry are of sufficient magnitude and can affect the refractive prediction of combined cataract surgery and trabeculectomy.
Al-Kalbani, M.; Mihaylova, E.; Collins, N.; Toal, V.; Coakley, D.; Boyle, G.
Ocular Microtremor (OMT) is a continual, high frequency physiological tremor of the eye present in all subjects even when the eye is apparently at rest. OMT causes a peak to peak displacement of around 150nm-2500nm with a broadband frequency spectrum between 30Hz to 120Hz; with a peak at about 83Hz. OMT carries useful clinical information on depth of consciousness and on some neurological disorders. Nearly all quantitative clinical investigations have been based on OMT measurements using an eye contacting piezoelectric probe which has low clinical acceptability. Laser speckle metrology is a candidate for a high resolution, non-contacting, compact, portable OMT measurement technique. However, tear flow and biospeckle might be expected to interfere with the displacement information carried by the speckle. The paper investigates the properties of the scattered speckle of laser light (λ = 632.8nm) from the eye sclera to assess the feasibility of using speckle techniques to measure OMT such as the speckle correlation. The investigation is carried using a high speed CMOS video camera adequate to capture the high frequency of the tremor. The investigation is supported by studies using an eye movement simulator (a bovine sclera driven by piezoelectric bimorphs). The speckle contrast and the frame to frame spatiotemporal variations are analyzed to determine if the OMT characteristics are detectable within speckle changes induced by the biospeckle or other movements.
McMain, Karen; Blake, Kim; Smith, Isabel; Johnson, Judy; Wood, Ellen; Tremblay, Francois; Robitaille, Johane
To detail the presence and severity of ocular and cranial nerve abnormalities found in individuals with CHARGE syndrome in a distinct geographic area. Nine individuals with CHARGE syndrome from Maritime Canada identified from a Canadian database were prospectively examined. Structural and sensorial defects associated with functional visual deficits were defined with ophthalmic and neurological evaluation. Consistent with current diagnostic criteria and the literature, colobomas were the major ophthalmic manifestation. These were typically bilateral chorioretinal colobomas involving the optic nerve. All subjects had bilateral severe sensorineural deafness (cranial nerve VIII), and 8 of 9 (89%) had facial nerve (cranial nerve VII) involvement (7 of 9 had unilateral involvement; 1 of 9 had bilateral involvement). Unique to this group of participants were the findings of anisometropia in 8 of the 9 (89%) patients, severe myopic astigmatism in 13 of the 18 eyes (72%), and limited elevation in adduction in 3 of 9 (33%) participants. Associated findings were strabismus, cataracts, microcornea, keratopathy, staphyloma, reduced stereopsis, superior visual field defects, and reduced visual acuity. The presence of coloboma plus another CHARGE feature warrants further investigation, including genetic screening for the CHD7 gene. Early recognition and management of sensory problems (visual, auditory, and vestibular) are crucial to ensure best psychomotor and cognitive development.
Leonardi, A; Doan, S; Fauquert, J L; Bozkurt, B; Allegri, P; Marmouz, F; Rondon, C; Jedrzejczak, M; Hellings, P; Delgado, L; Calder, V
Ocular allergy (OA) includes a group of common and less frequent hypersensitivity disorders frequently misdiagnosed and not properly managed. The diagnosis of OA is usually based on clinical history and signs and symptoms, with the support of in vivo and in vitro tests when identification of the specific allergen is required. To date, no specific test is available for the diagnosis of the whole spectrum of the different forms of OA. The lack of recommendations on diagnosis of OA is considered a medical need not only for allergists but also for ophthalmologists. This position paper aims to provide a comprehensive overview of the currently available tools for diagnosing OA to promote a common nomenclature and procedures to be used by different specialists. Questionnaires, sign and symptom grading scales, tests, and potential biomarkers for OA are reviewed. We also identified several unmet needs in the diagnostic tools to generate interest, increase understanding, and inspire further investigations. Tools, recommendations, and algorithms for the diagnosis of OA are proposed for use by both allergists and ophthalmologists. Several unmet needs in the diagnostic tools should be further improved by specific clinical research in OA. © 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.
Shaker, Marcus; Salcone, Erin
The update reviews prevalence, classification, cause, and treatment options for allergic eye disease. The incidence of allergic eye disease is underreported but may affect almost all patients with allergic rhinitis. Increased rates of oculonasal symptoms have been reported in the United States resulting in significant economic expenditures. The spectrum of allergic conjunctivitis and its differential considerations include seasonal and perennial conjunctivitis, vernal and atopic keratoconjunctivitis, and giant papillary conjunctivitis. Patients with allergic conjunctivitis have classic immunoglobulin E-mediated pathophysiology and treatments directed at allergen avoidance, traditional pharmacotherapy with oral antihistamines, topical dual-acting antihistamine/mast cell stabilizer agents, and treatment of tear film dysfunction are first-line management strategies. Immunotherapy is an effective treatment option and refractory cases may require ophthalmology comanagement for consideration of topical ester-based corticosteroid therapy and consideration of topical immunomodulators. Ocular allergy involving specific modifiable and treatable environmental sensitizations is common and often underrecognized. It can impair quality of life to varying degrees. Some cases are quite refractory to management and may require multidisciplinary coordination of care between allergy and ophthalmology specialists. Understanding classification, triggers, and treatment options is important in designing the most appropriate patient-tailored management plans.
McAllum, P; Barnes, R; Dickson, J
To invesitgate the incidence and severity of penetrating eye injuries caused by fencing wire in the Waikato region. We reviewed the case notes for all penetrating eye injuries treated at Waikato Hospital during the past six years. Parameters recorded were patient age and sex, mechanism of injury, initial visual acuity, characteristics of injury, surgery performed and final visual outcome. The incidence of penetrating eye injuries in the Waikato region was 3.8 per 100,000 per year, based on an estimated catchment population of 350,000. We found fencing wire to be the third most common cause of penetrating eye injury, accounting for 8.8% of injuries, behind motor vehicle accidents and hammering which accounted for 26.3% and 20.0% of injuries, respectively. The fencing wire injuries involved men exclusively, with an average age of 41.7 years. Fencing wire injuries had worse presenting visual acuity than other injuries, involved the posterior segment of the eye more frequently and were more likely to develop bacterial endophthalmitis. They also underwent more surgical procedures and were more commonly associated with a poor visual outcome. Fencing wire is an important cause of visual loss in the Waikato region. We hope to raise awareness of its potential ocular dangers and to promote the use of appropriate eye protection.
Ileana Miguel Pérez
Full Text Available Se realizó estudio retrospectivo longitudinal de pacientes con traumatismos oculares mecánicos hospitalizados en el Instituto Superior de Medicina Militar "Dr. Luis Díaz Soto", desde 1988 hasta el 2002, con una casuística de 508 ojos de 479 pacientes. El procesamiento estadístico fue realizado con el mismo programa automatizado con el que se conformó la base de datos (Acces y se utilizaron de acuerdo con las características de las variables ß analizadas métodos estadísticos paramétricos y no paramétricos con una confiabilidad de un 95 % (a =0,05. Se obtiene una relación de 4:1 de predominio del sexo masculino, con una edad promedio de 27,4 años con valor mínimo de 2 años y máximo de 78 años. Los mecanismos más frecuentes de producción del accidente resultaron ser: las armas de fuego (22,7 % y la acción de martillar (21,4 %, teniendo en cuenta que el 38,2 % de los pacientes fueron militares. Las lesiones asociadas a los traumatismos más frecuentes resultaron ser el hipema y el hemovítreo, y se demostró que a medida que eran mayores disminuía considerablemente la agudeza visual final. Los traumatismos cerrados (41,3 % fueron más frecuentes y tuvieron mejores resultados visuales finales (66,7 % con visión mayor de 0.1 que el resto de los grupos de traumatismos abiertos (herida simple, contusión-herida, herida con CEIO y contusión-herida con CEIO. Las contusiones-heridas con CEIO fueron provocados en su mayoría por las armas de fuego y tuvieron los peores resultados visuales (60,5 % con visión menor de 0.1. La afectación del segmento posterior resultó ser un elemento que influyó de forma importante en los resultados visuales. Las complicaciones más frecuentes para los traumatismos cerrados fueron la hipertensión secundaria la catarata y el desprendimiento de retina. Para las heridas simples la catarata y para el resto de los traumatismos el desprendimiento de retina y la ptisis bulbi. Aproximadamente el 15 % de
Shukla, Bhartendu; Agrawal, Rupesh; Shukla, Dhananjay; Seen, Sophia
The current classification of ocular trauma does not incorporate adnexal trauma, injuries that are attributable to a nonmechanical cause and destructive globe injuries. This study proposes a new classification system of ocular trauma which is broader-based to allow for the classification of a wider range of ocular injuries not covered by the current classification. A clinic-based cross-sectional study to validate the proposed classification. We analyzed 535 cases of ocular injury from January 1, 2012 to February 28, 2012 over a 4-year period in an eye hospital in central India using our proposed classification system and compared it with conventional classification. The new classification system allowed for classification of all 535 cases of ocular injury. The conventional classification was only able to classify 364 of the 535 trauma cases. Injuries involving the adnexa, nonmechanical injuries and destructive globe injuries could not be classified by the conventional classification, thus missing about 33% of cases. Our classification system shows an improvement over existing ocular trauma classification as it allows for the classification of all type of ocular injuries and will allow for better and specific prognostication. This system has the potential to aid communication between physicians and result in better patient care. It can also provide a more authentic, wide spectrum of ocular injuries in correlation with etiology. By including adnexal injuries and nonmechanical injuries, we have been able to classify all 535 cases of trauma. Otherwise, about 30% of cases would have been excluded from the study.
Gao, Yang; Kanengiser, Bruce E
The assessment of ocular irritation potential is an important part of safety testing for cosmetic and consumer products. The purpose of this investigation was to examine ocular irritancy levels elicited in humans by various categories of a specific class of cosmetic and consumer products that have a potential to enter the eye inadvertently during use. Test materials assessed belonged to one of seven categories, which included liquid makeup, shampoo, baby wash, mascara, eye makeup remover, powder eye shadow, and facial cleanser. These test materials were evaluated by human ocular instillation, followed by examinations, for which subjective perceptions of irritation were recorded, and component areas of ocular tissues were individually examined for inflammation and for the area and density of fluorescein staining patterns at 30 seconds and at 5, 15, 60, and 120 minutes post-instillation. Subjective and objective ocular irritation scores of 410 eyes were analyzed by product classification. Average score levels were determined for subjective responses, inflammation, and fluorescein staining patterns. This investigation determined that irritation levels of the evaluated test materials varied markedly with respect to product category, type of ocular irritation, and ocular tissue, demonstrating that these factors are important considerations for the prediction of the ocular irritancy of a test material.
Full Text Available Objective To investigate and analyze the clinical characters and prognosis of firearm ocular injury.Methods The traumatic characters of military inpatients with firearm-produced ocular injury(hospitalized in 15 military general hospitals during 2001-2005 were retrospectively reviewed and statistically analyzed.Results Of 716 military inpatients with ocular injuries(772 eyes,42(5.9%,all were men,aged 23.2±5.4 years were produced by firearm [with 60 injured eyes(7.8%].Among the 42 inpatients,18 cases(42.9% were binocular injury,and in 13 cases(31.0% it was complicated with brain and/or limb injury.The causes of injury included explosion(78.3% and foreign bodies in ocular region(68.3%,among which 41.7% of them with intraocular foreign bodies,and 72.0% were copper in nature.Combined ocular injuries were usually seen,but no endophthalmitis was found.Intraocular surgery was necessary for 61.7% of injured eyes,and vitrectomy was performed for 33.3% of injured eyes.According to the data collected at discharge from the hospital,15.0% of injured eyes were enucleated or eviscerated,8.3% showed monocular low vision and 11.9% binocular low vision,and 33.3% of them were monocular blind and 2.4% binocular blind.There was significant correlation between the post-traumatic visual acuity and the final vision(r=0.457,and the vision was improved significantly by treatment(P < .01.Conclusions The degree of trauma of firearm-induced ocular injury was usually severe and complicated with poor visual prognosis.Therefore the emphasis should be put on improvement of emergency and clinical treatment for firearm ocular injury.
Full Text Available The treatment goals for glaucoma are lowering the intraocular pressure and preservation of vision. Topical hypotensive drops are the standard form of therapy which is often associated with some symptoms of toxicity, ocular inflammation, allergy, or ocular surface disease (OSD. OSD is a common comorbidity in glaucoma patients, and its prevalence with glaucoma increases with age. Use of topical treatment could additionally increase symptoms of OSD mostly due to preservatives added to multidose medication bottles used to reduce the risk of microbial contamination. This toxicity has been particularly associated with BAK, the most commonly used preservative which damages conjunctival and corneal epithelial cells and significantly aggravates OSD symptoms. OSD adversely affects patients’ quality of life causing discomfort and problems with vision which in turn may result in noncompliance, lack of adherence, and eventually visual impairment. In the management of glaucoma patients OSD symptoms should not be overlooked. If they are present, topical glaucoma treatment should be adapted by decreasing the amount of drops instilled daily, using BAK-free or preservative-free medication and lubricants if necessary. Awareness of the presence and importance of OSD will in turn improve patients' adherence and compliance and thus ultimately the preservation of long-term vision.
Mohammad Reza Razeghinejad
Full Text Available Purpose: To compare ocular biometric parameters in primary angle closure suspects (PACS, primary angle closure glaucoma (PACG and acute primary angle closure (APAC. Methods: This cross-sectional study was performed on 113 patients including 33 cases of PACS, 45 patients with PACG and 35 subjects with APAC. Central corneal thickness (CCT, axial length (AL, anterior chamber depth (ACD and lens thickness (LT were measured with an ultrasonic biometer. Lens-axial length factor (LAF, relative lens position, corrected ACD (CACD and corrected lens position were calculated. The parameters were measured bilaterally but only data from the right eyes were compared. In the APAC group, biometric parameters were also compared between affected and unaffected fellow eyes. Logistic regression analysis was performed to identify risk factors. Results: No statistically significant difference was observed in biometric parameters between PACS and PACG eyes, or between affected and fellow eyes in the APAC group (P>0.05 for all comparisons. However, eyes with APAC had thicker cornea (P=0.001, thicker lens (P<0.0001, shallower ACD (P=0.009, shallower CACD (P=0.003 and larger LAF (P<0.0001. Based on ROC curve analysis, lower ACD, and larger LT, LAF and CCT values were associated with APAC. In the APAC group, LAF (P<0.0001 and CCT (P=0.001 were significant risk factors. Conclusion: This study revealed no significant difference in biometric characteristics in eyes with PACS and PACG. However, larger LAF and CCT were predictive of APAC.
Full Text Available Abstract Background To determine the ocular changes related to hypothyrodism in newly diagnosed patients without orbitopathy. Findings Thirty-three patients diagnosed to have primary overt hypothyroidism were enrolled in the study. All subjects were assigned to underwent central corneal thickness (CCT, anterior chamber volume, depth and angle measurements with the Scheimpflug camera (Pentacam, Oculus and cup to disc ratio (C/D, mean retinal thickness and mean retinal nerve fiber layer (RNFL thickness measurements with optical coherence tomography (OCT in addition to ophthalmological examination preceeding the replacement therapy and at the 1st, 3rd and 6th months of treatment. The mean age of the patients included in the study were 40.58 ± 1.32 years. The thyroid hormone levels return to normal levels in all patients during the follow-up period, however the mean intraocular pressure (IOP revealed no significant change. The mean CCT was 538.05 ± 3.85 μ initially and demonstrated no statistically significant change as the anterior chamber volume, depth and angle measurements did. The mean C/D ratio was 0.29 ± 0.03 and the mean retinal thickness was 255.83 ± 19.49 μ initially and the treatment did not give rise to any significant change. The mean RNFL thickness was also stable during the control visits, so no statistically significant change was encountered. Conclusions Neither hypothyroidism, nor its replacement therapy gave rise to any change of IOP, CCT, anterior chamber parameters, RNFL, retinal thickness and C/D ratio.
Raiza Vega Montalvo
Full Text Available El ojo puede ser dañado accidentalmente por el uso de muchos productos de uso rutinario. Para facilitar la seguridad de los consumidores es necesario estimar el potencial de irritación ocular de estas sustancias químicas. Esta estimación está basada en los resultados obtenidos en el ensayo de Draize llevado a cabo en conejos. Sin embargo, avances en el desarrollo de la toxicología in vitro han permitido el uso de algunas alternativas para la evaluación del riesgo ocular; por lo que se presenta una revisión acerca de los diferentes métodos alternativos disponibles hasta el momento que permiten evaluar de una forma u otra los efectos tóxicos a nivel ocular.The eye may be accidentally damaged by many products of daily use. To guarantee the consumers’ safety it is necessary to estimate the eye irritation potential of these chemical substances. This estimation is based on the results obtained in the Draize rabbit eye irritation test. However, the advances attained in the development of in vitro toxicology have allowed the use of some alternatives to evaluate the ocular risk. Therefore, a review is made on the different alternative methods available up to now that make possible the evaluation in one way or another of the toxic effects at the ocular level.
S. Yu. Petrov
Full Text Available Despite the fact that the eye represents a challenge for biomechanical research due to its size, over the last two decades, much data on ocular biomechanics were accumulated. Scleral and lamina cribrosa biomechanics contribute to our understanding of myopia and open-angle glaucoma; iris and trabecular meshwork biomechanics to that of angle-closure glaucoma; vitreous biomechanics to that of retinal detachment and ocular drug delivery; corneal biomechanics to that of keratoconus; and lens capsule biomechanics to that of cataract. This paper offers a general overview of recent advances in corneal, scleral, crystalline lens, and lamina cribrosa biomechanics and summarizes the results of experimental and clinical studies. Ocular biomechanics abnormalities affect etiology of many eye diseases. Ocular biomechanics plays an important role in the development of novel diagnostic methods, therapeutic and surgical procedures. Corneal biomechanics impacts etiology and pathogenesis of keratoconus as well as tonometry accuracy and explains corneal refractive surgery effect. Scleral biomechanics is associated with IOP and progressive myopia. Accommodative apparatus (ciliary body and crystalline lens is an important anatomic physiological structure. Recent studies uncovered the causes of agerelated loss of accommodation as a result of lens involution. Optic nerve head abnormalities due to IOP fluctuations are the key factor of glaucomatous neuropathy. They are directly associated with ocular biomechanics as well.
S. Yu. Petrov
Full Text Available Despite the fact that the eye represents a challenge for biomechanical research due to its size, over the last two decades, much data on ocular biomechanics were accumulated. Scleral and lamina cribrosa biomechanics contribute to our understanding of myopia and open-angle glaucoma; iris and trabecular meshwork biomechanics to that of angle-closure glaucoma; vitreous biomechanics to that of retinal detachment and ocular drug delivery; corneal biomechanics to that of keratoconus; and lens capsule biomechanics to that of cataract. This paper offers a general overview of recent advances in corneal, scleral, crystalline lens, and lamina cribrosa biomechanics and summarizes the results of experimental and clinical studies. Ocular biomechanics abnormalities affect etiology of many eye diseases. Ocular biomechanics plays an important role in the development of novel diagnostic methods, therapeutic and surgical procedures. Corneal biomechanics impacts etiology and pathogenesis of keratoconus as well as tonometry accuracy and explains corneal refractive surgery effect. Scleral biomechanics is associated with IOP and progressive myopia. Accommodative apparatus (ciliary body and crystalline lens is an important anatomic physiological structure. Recent studies uncovered the causes of agerelated loss of accommodation as a result of lens involution. Optic nerve head abnormalities due to IOP fluctuations are the key factor of glaucomatous neuropathy. They are directly associated with ocular biomechanics as well.
Full Text Available Introduction: Chronic renal disease compromises of several renal involvements and several causative risk factors such as debates mellitus, hypertension, and old age. Ocular involvement seems to be related to chronic renal failure and hemodialysis as indicated by different studies. The aim of this study was the evaluation of prevalence of ocular manifestation in hemodialysis patients of Hamadan Besat hospital. Methods: This research was a cross sectional descriptive study, in which ocular signs in 74 hemodialysis patients, who referred to Besat hospital of Hamadan, Iran, during year 2015, were evaluated. Collected information related to patients included age, gender, dialysis duration, and background risk factors of chronic renal failure. All patients had been exanimated by an ophthalmologist. Results: Fifty percent of patients in the study were male and 50% were female. Average age of patients was 58.8 years and median duration of dialysis was 40.16 months. Mean visual acuity was 4.58 (of 10. Most common ocular manifestations were: macula abnormality (59.5%, cataract (56.7%, eye pain (56.7%, eye redness (52.7%, dry eyes (50%, and eyelid edema (43.2%, respectively. Conclusions: Hypertension and diabetes mellitus are the most common causes of chronic renal failure. The most common ocular manifestations were macular abnormality followed by cataract. According to high prevalence of these complications in hemodialysis patients, regular monitoring of patients for early detection and thus effective treatment seems to be necessary to improve their quality of life
Full Text Available Introduction: The integrity of the cells/tissues in anterior and/or posterior segments of the eye plays a crucial role in biofunctions of the vision. To maintain ocular homeostasis, selective restrictiveness of the ophthalmic membranes and barriers control must act on shuttling of biomolecules. Thus, not all attempts to apply de novo nanotechnology approaches for ocular pharmacotherapy have met with the same successes as those cited here in this review, and sometimes these novel technologies tools provoke a great deal of challenges and hurdles mainly because of functional presence of these barriers. Methods: Recent published articles related to application of ocular nanomedicines were reviewed and highlighted in this review article. Results: It seems the emergence of nanomedicines have arisen great hopes for ophthalmic pharmacotherapy, in which nanostructured medicines are expected to be able to cross the restrictive barriers of the eye. Although such fast inauguration of ocular nanomedicines will literally convey new challenges in the regulatory and translational processes, it will also grant a prolific platform from which many exciting, and yet unimagined, applications of biomedical nanotechnology will emerge for pharmacotherapy of the eye. Conclusion: This review provide recent advancements on ocular nanomedicines.
Lee, Seok Hyun; Chun, Yeoun Sook; Kim, Jae Hoon; Kim, Eung Suk; Kim, Jae Chan
To determine the correlative relationship between the prevalence of Demodex in eyelashes and the severity of ocular discomfort, by investigating the demographic epidemiology associated with Demodex. One hundred seventy patients underwent epilation of four eyelashes of each eye, and the number of Demodex was counted. The patients answered questionnaires about ocular surface discomfort and underwent ophthalmic examinations, including slit lamp, tear film breakup time (BUT), Schirmer test, and microbial culturing. The correlative relationship between the number of Demodex and these variable data was analyzed. Demodex was found in 120 (70%) of the 170 tested patients. Of 1360 eyelashes, 740 (54%) had Demodex. There was no significant difference in the prevalence of Demodex between males and females (P = 0.35). The number of Demodex showed significant positive correlations with increased age, ocular discomfort, and 1/BUT (P Demodex was significantly higher in patients with conjunctival papillary hypertrophy than in those without (P = 0.003). The presence or distribution of bacteria on eyelashes was similar between eyelids with and without Demodex. However, methicillin-resistant Staphylococcus aureus (MRSA) was detected more often on eyelids with Demodex, but this difference was not statistically significant. There is a strong correlation between the number of Demodex and the severity of ocular discomfort, suggesting that Demodex plays a pathogenic role in the ocular discomfort linked with aging.
Hargrave, S; Weakley, D; Wilson, C
To evaluate the ocular complications of paintball injuries in children. The clinical course of four children with traumatic ocular paintball injuries was evaluated. All patients underwent a complete ocular examination. Their age, injuries sustained, surgical procedure(s) performed, presence of protective eyewear at the time of injury, and final visual outcome was assessed. The presence of directly related anterior and posterior segment abnormalities were also evaluated. Four boys sustained traumatic paintball injuries. Average patient age was 11.25 years (range: 10-12 years). None of the children were wearing ocular or facial protection at the time of the initial injury. All patients had hyphema and traumatic cataract, and some form of retinal pathology (vitreous hemorrhage, epiretinal membrane, retinal hemorrhage, and choroidal rupture). One child had a partial-thickness corneal laceration that did not require surgical intervention. All other patients underwent ophthalmic surgery. Final visual acuity was 20/30 or better in two patients, and 20/100 or worse in the others. The cause of decreased visual acuity in these children was directly related to macular pathology. Ocular injuries resulting from paintball impact are often severe and usually occur when the participants are not wearing eye protection or this protection becomes dislodged. Treatment of these injuries is sometimes limited to an attempt to salvage what remains of useful vision. Unfortunately, most of these sports-related injuries could have been prevented if patients wore adequate eye protection when involved in this sport.
Full Text Available Transport of drugs applied by traditional dosage forms is restricted to the eye, and therapeutic drug concentrations in the target tissues are not maintained for a long duration since the eyes are protected by a unique anatomy and physiology. For the treatment of the anterior segment of the eye, various droppable products to prolong the retention time on the ocular surface have been introduced in the market. On the other hand, direct intravitreal implants, using biodegradable or non-biodegradable polymer technology, have been widely investigated for the treatment of chronic vitreoretinal diseases. There is urgent need to develop ocular drug delivery systems which provide controlled release for the treatment of chronic diseases, and increase patient’s and doctor’s convenience to reduce the dosing frequency and invasive treatment. In this article, progress of ocular drug delivery systems under clinical trials and in late experimental stage is reviewed.
Mukhopadhyay, Somnath; Shome, Subrata; Bar, Prasenjit Kumar; Chakrabarti, Amit; Mazumdar, Swati; De, Avisek; Sadhukhan, Kaushik; Bala, Bivas
Rhinosporidiosis, a granulomatous disease caused by Rhinosporidium seeberi, is widely prevalent in Sri Lanka and southern parts of India. Besides the eye, the lacrimal passage and nasal cavity are affected. The most common ocular involvement is a subconjunctival bleeding mass. Our case, a 9-year-old girl from a rural background with a history of pond water bathing, presented with a marginal chalazion involving the left lower lid. She had a history of chalazion involving the same site three months earlier which was managed by incision and curettage. A decision of surgical exploration was made and the evacuated mass was examined histologically showing evidence of rhinosporidiosis. This type of clinical presentation for ocular rhinosporidiosis (as recurrent chalazion) has not been reported earlier in the literature. This case emphasises that the clinicians from this part of the world must consider ocular rhinosporidiosis as differential diagnosis in cases with recurrent chalazion especially in a rural background with a habit of pond water bathing.
Raja, Harish; Starr, Matthew R; Bakri, Sophie J
Tick-borne illnesses are a significant disease burden worldwide. Diagnosis is challenging and requires a high level of clinical suspicion. Ocular manifestations reported in association with tick-borne disease are mostly as case reports and small case series because of the relative infrequency with which they occur; however, given the global nature of health care and increase in travel in the 21st century, it is important for ophthalmologists to be aware of ocular manifestations of these diseases because early diagnosis may reduce morbidity and mortality. Here, we review of the literature of tick-borne diseases with reported ophthalmic findings. All known human tick-borne diseases are discussed, including a brief description of the causative agent, region of endemicity, vector, systemic symptoms, and any reported eye findings. When possible, we also address the strength of the evidence for these ocular associations. Copyright © 2016 Elsevier Inc. All rights reserved.
Ganley, J.P.; Nemo, G.J.; Comstock, G.W.; Brody, J.A.
Lymphocytes from individuals with inactive macular disciform lesions of presumed ocular histoplasmosis challenged with three histoplasmin antigens incorporated tritiated thymidine at a significantly higher rate than histoplasmin-stimulated lymphocytes of matched control and peripheral scar groups. This finding is consistent with the etiologic association of the disciform ocular syndrome and previous systemic infection with Histoplasma capsulatum. The disciform group had a higher mean response than the other two groups to pokeweed mitogen but not to phytohemagglutinin and had higher mean counts per minute to the specific antigens Toxoplasma gondii, Blastomyces dermatitidis, Cryptococcus neoformans, Mycobacterium tuberculosis, M battery, and M gaus, but not to Candida albicans. These data would suggest that individuals with the disciform lesion of presumed ocular histoplasmosis have a hyperreactive cellular immune response; this response may play an important role in the development of the disciform.
Mackay, Devin D; Garza, Philip S
The proficiency of nonophthalmologists with direct ophthalmoscopy is poor, which has prompted a search for alternative technologies to examine the ocular fundus. Although ocular fundus photography has existed for decades, its use has been traditionally restricted to ophthalmology clinical care settings and textbooks. Recent research has shown a role for nonmydriatic fundus photography in nonophthalmic settings, encouraging more widespread adoption of fundus photography technology. Recent studies have also affirmed the role of fundus photography as an adjunct or alternative to direct ophthalmoscopy in undergraduate medical education. In this review, the authors examine the use of ocular fundus photography as an educational tool and suggest future applications for this important technology. Novel applications of fundus photography as an educational tool have the potential to resurrect the dying art of funduscopy. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Journal Home > Vol 100, No 3 (2010) > ... We examined the sensitivity of Hutchinsonfs sign as an indicator of ocular involvement in a consecutive ... Neither age nor CD4 count had predictive value for ocular involvement. ... Article Metrics.
Haitham H Al-Mahrouqi
CONCLUSION: Ocular trauma is a common presentation at Al-Nahdha Hospital. Although the majority of trauma cases were minor without any resultant visual disability, OGI could have been prevented with better ocular protection in the workplace.
Ng, Alison; Evans, Katharine; North, Rachel; Purslow, Christine
Eye cosmetics usage is commonplace and whilst some products such as eyeliner are applied with close proximity to the ocular surface, there is little knowledge of the short- and long-term ocular effects of eye cosmetic formulations. This study aimed to investigate the use of eye cosmetics and identify any relationships between ocular comfort and cosmetic usage. Results were collated from an online survey comprising 23 questions that recorded demographics, Ocular Surface Disease Index (OSDI) score, extent and range of eye cosmetic use and perceived comfort differences with and without eye cosmetics. The 1360 female respondents (median age 25, interquartile range 20-34 years) completed the survey; 83% reported using eye cosmetics regularly (≥ 3 times per week) with mascara being most commonly used. Fifty three per cent used at least three different eye cosmetics products regularly. OSDI scores of cosmetics users were similar to non-users (p = 0.083), but perceived comfort was greater when cosmetics were not used (p cosmetics users (use of products cosmetics were used. Median OSDI scores suggested a trend towards reduced comfort amongst eyeliner users (p = 0.07) although frequency and type of cosmetic products used did not appear to influence OSDI scores. This study shows the use of multiple eye cosmetics is extensive and associated with the perception of ocular discomfort. With such widespread use of these products, more research is required to assess the effect on the ocular surface and tear film, which may be underestimated. Ophthalmic & Physiological Optics © 2012 The College of Optometrists.
Gabal, M S; Raslan, O A
Mercury vapor exposed workers may show ocular changes, as well as other systems affection. A sample of 84 workers in preparing mercury fulminate were examined for conjunctival corneal and lenticular manifestation of long duration exposure, together with mercury urinary output. Lens changes were found in 50% of the involved workers while keratopathy as recorded in 34.5% of them. No statistically significant association was found between the occurrence of eye lesions and levels of urinary elimination of mercury. These results suggest local absorption of this element is most probably the underlying cause of ocular affection.
D. Lopes-Ferreira; Neves, H; A. Queiros; Faria-Ribeiro, M.; Peixoto-de-Matos, S. C.; J. M. González-Méijome
To show the distribution of ocular dominance as measured with sensory and eye sighting methods and its potential relationship with high and low contrast LogMAR visual acuity in presbyopic subjects. Method. Forty-four presbyopes (48.5 ± 3.5 years) participated in this study. Ocular dominance was determined by eye sighting (hole-in-card) and sensorial (+1.50 D lens induced blur) methods. According to the dominance detected with each method (RE: right eye or LE: left eye), patients were classifi...
L. Gila; Villanueva, A; Cabeza, R
En el control de la motilidad ocular intervienen varios sistemas funcionales. Los reflejos vestíbulo-oculares y optocinéticos son respuestas automáticas para compensar los movimientos de la cabeza y del entorno visual y poder estabilizar la imagen retiniana sobre un determinado punto de fijación. Los movimientos sacádicos son rápidos desplazamientos de la fijación de un punto a otro del campo visual. Los movimientos de persecución lenta consisten en el seguimiento de estímulos móviles con la ...
Full Text Available Ocular surface squamous neoplasia originates from conjunctiva epithelium and covers a broad spectrum of disease ranging from dysplasia to squamous cell carcinoma. Clinical features may vary from case to case. Traditional treatment of excision with no-touch technique combined with adjuvant therapies because of high recurrence rate. Main adjuvant treatments are cryotherapy and chemotherapy. In this review, clinical forms, differential diagnosis, American Joint Committee on Cancer classification and recent approaches to the management of ocular surface squamous dysplasia were described. (Turk J Ophthalmol 2014; 44: Supplement 8-14
Reichl, Lars; Löwel, Siegrid; Wolf, Fred
We present an analytical approach for studying the coupled development of ocular dominance and orientation preference columns. Using this approach we demonstrate that ocular dominance segregation can induce the stabilization and even the production of pinwheels by their crystallization in two types of periodic lattices. Pinwheel crystallization depends on the overall dominance of one eye over the other, a condition that is fulfilled during early cortical development. Increasing the strength of intermap coupling induces a transition from pinwheel-free stripe solutions to intermediate and high pinwheel density states.
Wallace, G R; Niemczyk, E
The ability to identify individuals at risk of ocular disease, or to determine the potential severity of disease or response to therapy is the current focus of much research. These studies are being led by genetic analysis of individuals to determine associations with alterations in gens that may explain manifestations of particular diseases. In this review we consider the basic principles behind genetic studies in general and of ocular disease in particular. We address the methodologies being utilised, and the results derived so far. The potential and pitfalls of such studies are relevant to the concept of personalised medicine and better defined clinical trials.
Pakravan, Mohammad; Alvani, Azam; Esfandiari, Hamed; Ghahari, Elham; Yaseri, Mehdi
Trabeculectomy is the most common surgical procedure for the management of glaucoma, which may significantly influence ocular biometry. Axial length and anterior chamber depth tend to decrease, while crystalline lens and choroidal thickness increase post-operatively. An increase in with-the-rule astigmatism is also observed after the procedure. Such biometric changes affect intraocular lens power calculation even years after the procedure. Non-contact biometric methods and postponing cataract surgery after trabeculectomy could reduce calculation errors associated with surgically induced alterations in ocular biometrics. © 2016 Optometry Australia.
van Wijngaarden, Peter; Hadoux, Xavier; Alwan, Mostafa; Keel, Stuart; Dirani, Mohamed
Interest in reliable biomarkers of Alzheimer disease, the leading cause of dementia, has been fuelled by challenges in diagnosing the disease and monitoring disease progression as well as the response to therapy. A range of ocular manifestations of Alzheimer disease, including retinal and lens amyloid-beta accumulation, retinal nerve fiber layer loss, and retinal vascular changes, have been proposed as potential biomarkers of the disease. Herein, we examine the evidence regarding the potential value of these ocular biomarkers of Alzheimer disease. © 2016 Royal Australian and New Zealand College of Ophthalmologists.
Simone Ribeiro Araújo de Almeida
Full Text Available OBJETIVO: Analisar os achados clínicos da tuberculose ocular e seus aspectos epidemiológicos. MÉTODOS: Foram revisados prontuários médicos de pacientes que foram atendidos no Departamento de Oftalmologia - setor de Uveíte e AIDS da Unifesp-EPM, São Paulo, Brasil, entre janeiro de 1999 e julho de 2002 e que tiveram diagnóstico de tuberculose ocular. Foram inclusos os pacientes que apresentaram PPD forte reator, epidemiologia positiva para tuberculose e lesão ocular que melhorou com tratamento específico. RESULTADOS: Foram analisados prontuários médicos de 17 pacientes, sendo 12 (70,6% do sexo feminino. A idade média foi de 54 (24-84 anos. O tempo médio entre o início dos sintomas e a primeira consulta foi de 100 dias. Os achados oculares foram inespecíficos nesta ocasião mas prevaleceram as alterações de segmento anterior e 41% dos pacientes apresentavam sinais de tuberculose sistêmica. Alterações como glaucoma, descolamento de retina e hemorragia vítrea foram responsáveis pela redução da acuidade visual. CONCLUSÃO: Embora pouco prevalente, a tuberculose ocular apresenta morbidade elevada. A inespecificidade da apresentação clínica da doença ocular pode atrasar o seu diagnóstico.PURPOSE: To analyze clinical findings of ocular tuberculosis and its epidemiological features. METHODS: Were reviewed clinical files of patients who attended the Ophthalmology - Uveitis and AIDS sector of UNIFESP-EPM, São Paulo, Brazil between January 1999 and July 2002 and had a diagnosis of ocular tuberculosis. Patients who had Mantoux test higher than 10 mm, epidemiological history of tuberculosis and ocular findings that improved after specific treatment were included. RESULTS: Seventeen medical files were analyzed, of those, 12 (70,6% were females. The mean age was 54 (24-84 years. The average time between symptoms and diagnosis was 100 days. Ocular findings at the first interview were multiple but most were at the anterior segment of
Final visual acuity depended on presenting visual acuity, how early in the disease patients presented, degree of inflammation and the degree of ocular surface cicatrisation. Conclusion: Ocular involvement in SJS results in widely differing degrees of ocular disability. Management involves medications and surgery.
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ocular surgery irrigation device. 886.4360 Section... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4360 Ocular surgery irrigation device. (a) Identification. An ocular surgery irrigation device is a device intended to be suspended over the...
Background: Ocular surface squamous neoplasia (OSSN)are aspectrum of lesions that arise from the squamous epithelium of the conjunctiva and cornea. They form the most frequent indication for orbital exenteration in Korle-bu Teaching Hospital, Accra. Poor management of early lesions leads to high rates of tumour ...
Nadareĭshvili, T B; Pakhomova, T S; Labutina, L V; Kachko, A L
A critical analysis has been attempted of the current state-of-the-art in studying seleno-cadmium ruby glasses applicable for glass ocular prosthesis production. Better quality of these prostheses can be achieved by both the refinement of the ruby glass composition and by its strengthening (hardening) through proper methods.
Full Text Available Eleven histologically proved cases of ocular malignant lymphoma diagnosed and managed during the year 1974-81 are reported. The follow-up period ranges from 2-7 years. The difficulties in diagnosis, treatment and prognosis are discussed.
Holly A. Unterhorst
Full Text Available Wavefront aberrations can be described as deviations of the wavefront exiting the eye froma reference wavefront that is aberration free and diffraction limited. Ocular aberrations canbe sub-categorised as lower and higher order aberrations. Ocular aberrations have promptedinterest amongst the ocular healthcare community owing to their influences on the visualfunctioning of patients as well as differences observed in ocular aberrations through the useof refractive surgery both pre- and post-operatively. Uncompensated refractive error remainsone of the most common reasons for which patients consult optometrists. Compensationof refractive error, or lower order aberrations, has become a routine procedure during anoptometric examination. However, there are some patients who experience visual symptomseven after their refractive errors have been compensated via spectacles or contact lenses.Higher-order aberrations may be the source of these visual disturbances. Refractive surgeryhas been found to influence and even induce various changes in higher-order aberrationspost-operatively, which in turn has led to increased interest in wavefront aberrations and howthe measurement of these aberrations can improve diagnosis and treatment within optometryand ophthalmology.
Tuft, S J; Shortt, A J
Chemical and thermal burns can cause devastating injuries to the anterior segment. The consequences of alkali injuries are notoriously severe due to the rapid penetration of these agents into the ocular tissues. Denaturation of tissue, inflammation, and scarring leads to loss of function. An understanding of the pathogenesis of tissue damage has lead to a rational approach to treatment. Emergency irrigation of the eye is essential and there is a 'window of opportunity' during the first 7-10 days after injury when medical treatment can significantly limit the potentially blinding consequences. The acute injury is followed by early and late reparative phases during which the prognosis can be further improved by surgical intervention. Early surgical intervention is targeted at protecting the ocular surface and encouraging re-epithelisation. Later, surgical treatments are directed at ocular surface reconstruction and restoration of vision. However, before any attempt is made at surface reconstruction, the ocular surface environment must be optimised by division of symblepharon, and correction of lid deformity and trichiasis. If there is conjunctivalisation of the corneal surface, limbal stem cell transplantation can restore a corneal epithelial cell phenotype, and transplantation of in vitroamplified corneal epithelial stem cells has been developed as an alternative to keratolimbal transfer techniques. Keratoplasty and cataract surgery may then be necessary to clear the visual axis. Finally, keratoprosthesis is an option for the most severely damaged eyes.
Sharma, Namrata; Kaur, Manpreet; Agarwal, Tushar; Sangwan, Virender S; Vajpayee, Rasik B
Ocular chemical burns are an ophthalmic emergency and are responsible for 11.5%-22.1% of ocular injuries. Immediate copious irrigation is universally recommended in acute ocular burns to remove the offending agent and minimize damage. Conventional medical therapy consists of the use of agents that promote epithelialization, minimize inflammation, and prevent cicatricial complications. Biological fluids such as autologous serum, umbilical cord blood serum, platelet-rich plasma, and amniotic membrane suspension are a rich source of growth factors and promote healing when used as adjuncts to conventional therapy. Surgical treatment of acute ocular burns includes the debridement of the necrotic tissue, application of tissue adhesives, tenoplasty, and tectonic keratoplasty. Amniotic membrane transplantation is a novel surgical treatment that is increasingly being used as an adjunct to conventional treatment to promote epithelial healing, minimize pain, and restore visual acuity. Various experimental treatments that aim to promote wound healing and minimize inflammation are being evaluated such as human mesenchymal and adipose stem cells, beta-1,3 glucan, angiotensin-converting enzyme inhibitors, cultivated fibroblasts, zinc desferrioxamine, antifibrinolytic agents, antioxidants, collagen cross-linking, and inhibitors of corneal neovascularization. Copyright © 2017 Elsevier Inc. All rights reserved.
Vincent, Stephen J; Collins, Michael J; Read, Scott A; Carney, Leo G
Anisometropia represents a unique example of ocular development, where the two eyes of an individual, with an identical genetic background and seemingly subject to identical environmental influences, can grow asymmetrically to produce significantly different refractive errors. This review provides an overview of the research examining myopic anisometropia, the ocular characteristics underlying the condition and the potential aetiological factors involved. Various mechanical factors are discussed, including corneal structure, intraocular pressure and forces generated during near work that may contribute to development of anisomyopia. Potential visually guided mechanisms of unequal ocular growth are also explored, including the influence of astigmatism, accommodation, higher-order aberrations and the choroidal response to altered visual experience. The association between binocular vision, ocular dominance and asymmetric refraction is also considered, along with a review of the genetic contribution to the aetiology of myopic anisometropia. Despite a significant amount of research into the biomechanical, structural and optical characteristics of anisometropic eyes, there is still no unifying theory, which adequately explains how two eyes within the same visual system grow to different endpoints. © 2014 The Authors. Clinical and Experimental Optometry © 2014 Optometrists Association Australia.
Intra ocular lens implantation is a relatively new surgical procedure in developing countries, although it has been the norm in developed countries for over three decades. It is carried out during cataract surgery for the purpose of aphakic correction. The aim of the study was to assess the level of awareness of the general ...
and retroperitoneal regions of the body.1. Teratomas arising from the head and neck region are uncommon.4 We report a case of orbito-ocular teratoma in an infant. Case Report. A seventeen day-old baby ... intestinal glands and neural tissue with retinoblasts showing severe anaplasia. There was local infiltration and foci ...
Malaria is endemic in Nigeria. With the emergence of chloroquine resistance various modes of treatment including parenteral quinine are employed with consequent untoward effects. This article reports two cases of severe ocular toxicity, including mimicry of intracranial space‑occupying lesion, from treatment of malaria ...
areas of medicine (Aoki et al 1987; Grote 1987; Shin et al 1992) also. The use of hydroxyapatite as an ocular .... the experimental error, throughout the whole process of fabrication. The median particle size of HAp powder used ... per medication and resolution took place within the 12th post-operative day (figures 9 a–d).
de Vries, Jan Willem
The field of DNA nanotechnology has progressed rapidly in recent years and now offers facile fabrication of a large variety of nanostructures of different shapes and geometries. In this thesis, short nucleic acid sequences are functionalized with hydrophobic units to form the basis of an ocular drug
The evolutionary and developmental changes in the eye muscle innervation, the inner ear, and the vestibulo-ocular reflex are examined. Three eye muscle patterns, based on the innervation by distinct ocular motoneurons populations, can be identified: a lamprey, an elasmobranch, and a bony fish/tetrapod pattern. Four distinct patterns of variation in the vestibular system are described: a hagfish pattern, a lamprey pattern, an elasmobranch pattern, and a bony fish/tetrapod pattern. Developmental data suggest an influence of the hindbrain on ear pattern formation, thus potentially allowing a concomitant change of eye muscle innervation and ear variation. The connections between the ear and the vestibular nuclei and between the vestibular nuclei and ocular motoneurons are reviewed, and the role of neurotrophins for pattern specification is discussed. Three patterns are recognized in central projections: a hagfish pattern, a lamprey pattern, and a pattern for jawed vertebrates. Second-order connections show both similarities and differences between distantly related species such as lampreys and mammals. For example, elasmobranchs lack an internuclear system, which is at best poorly developed in lampreys. It is suggested that the vestibulo-ocular system shows only a limited degree of variation because of the pronounced functional constraints imposed on it.
Jul 10, 2012 ... A snakebite constitutes a common acute medical emergency and has several systemic and even ocular consequences. According to Patil et al,1 the importance of this public health problem has largely been ignored by medical science. There are approximately 3 000 snake species worldwide, of which ...
Ailén Garcés Fernández
Full Text Available El síndrome isquémico ocular es caracterizado por síntomas y signos oculares secundarios a la estenosis severa y prolongada ipsilateral de la arteria carótida interna extracraneal o de la arteria carótida común, ocasionalmente, se ha asociado a la oclusión de la arteria oftálmica. En general, se considera un diagnóstico poco usual y constituye la tercera causa más común de glaucoma neovascular con pobre pronóstico visual. Hallazgos oculares incluyen disminución progresiva de la visión, inflamación del segmento anterior, neovascularización del iris y del ángulo iridocorneal, glaucoma neovascular y retinopatía por hipoperfusión periférica. Describimos un paciente con severa estenosis carotídea ipsilateral y disminución progresiva de la visión por la isquemia ocular. Se realiza una revisión sobre el manejo de esta condición tan controversial.Ocular ischemic syndrome is characterized by ocular symptoms and signs that are secondary to prolonged and severe ipsilateral stenosis of extracranial internal carotid artery or of the common carotid artery; occasionally, ipsilateral ophthalmic artery obstruction can also be responsible. It is generally considered as an unusual diagnosis, and the 3rd most common cause in neovascular glaucoma with poor visual prognosis. Ocular findings include gradual onset of decreased vision, inflammation of the anterior segment, iris and iridocorneal angle neovascularization, neovascular glaucoma and peripheral hypoperfusion retinopathy. Here is a patient with l severe ipsilateral carotid stenosis and progressive visual loss due to ocular ischemia. A literature review on the best management of this so controversial condition was made.
Full Text Available Purpose: The current classification of ocular trauma does not incorporate adnexal trauma, injuries that are attributable to a nonmechanical cause and destructive globe injuries. This study proposes a new classification system of ocular trauma which is broader-based to allow for the classification of a wider range of ocular injuries not covered by the current classification. Methods: A clinic-based cross-sectional study to validate the proposed classification. We analyzed 535 cases of ocular injury from January 1, 2012 to February 28, 2012 over a 4-year period in an eye hospital in central India using our proposed classification system and compared it with conventional classification. Results: The new classification system allowed for classification of all 535 cases of ocular injury. The conventional classification was only able to classify 364 of the 535 trauma cases. Injuries involving the adnexa, nonmechanical injuries and destructive globe injuries could not be classified by the conventional classification, thus missing about 33% of cases. Conclusions: Our classification system shows an improvement over existing ocular trauma classification as it allows for the classification of all type of ocular injuries and will allow for better and specific prognostication. This system has the potential to aid communication between physicians and result in better patient care. It can also provide a more authentic, wide spectrum of ocular injuries in correlation with etiology. By including adnexal injuries and nonmechanical injuries, we have been able to classify all 535 cases of trauma. Otherwise, about 30% of cases would have been excluded from the study.
Roy, Somak; Pantanowitz, Liron; Amin, Milon; Seethala, Raja R; Ishtiaque, Ahmed; Yousem, Samuel A; Parwani, Anil V; Cucoranu, Ioan; Hartman, Douglas J
Photomicrographs in Anatomic Pathology provide a means of quickly sharing information from a glass slide for consultation, education, documentation and publication. While static image acquisition historically involved the use of a permanently mounted camera unit on a microscope, such cameras may be expensive, need to be connected to a computer, and often require proprietary software to acquire and process images. Another novel approach for capturing digital microscopic images is to use smartphones coupled with the eyepiece of a microscope. Recently, several smartphone adapters have emerged that allow users to attach mobile phones to the microscope. The aim of this study was to test the utility of these various smartphone adapters. We surveyed the market for adapters to attach smartphones to the ocular lens of a conventional light microscope. Three adapters (Magnifi, Skylight and Snapzoom) were tested. We assessed the designs of these adapters and their effectiveness at acquiring static microscopic digital images. All adapters facilitated the acquisition of digital microscopic images with a smartphone. The optimal adapter was dependent on the type of phone used. The Magnifi adapters for iPhone were incompatible when using a protective case. The Snapzoom adapter was easiest to use with iPhones and other smartphones even with protective cases. Smartphone adapters are inexpensive and easy to use for acquiring digital microscopic images. However, they require some adjustment by the user in order to optimize focus and obtain good quality images. Smartphone microscope adapters provide an economically feasible method of acquiring and sharing digital pathology photomicrographs.
Tabatabaei, Seyed Ali; Modanloo, Shokoufeh; Ghiyasvand, Arezoo Mohammadkhani; Pouryani, Abolghasem; Soleimani, Mohammad; Tabatabaei, Seyed Mehdi; Pakrah, Ahmad Reza; Masarat, Hamideh
To report the frequency, associated risk factors and characteristics of cases referred to Farabi Eye Hospital with ocular superglue injuries. In a descriptive cross-sectional study conducted between December 2012 and February 2013, patients with ocular superglue injuries were evaluated. Age, sex, educational level, location, time, mechanism, type, site and time of eye injury were gathered through interview using a customized questionnaire. All participants had given consent to undergo thorough eye examination. Over the course of three months, 105 patients with ocular superglue injuries enrolled in the study, including 56(53.3%) men and 49(46.7%) women with the mean age of 24.7±11.6 (range, 2 to 53)y. The right eye, left eye and both eyes were involved in 52%, 42% and 6% of the patients, respectively. Most of injuries had occurred at home (72.4%) and at night (55%). More than half of patients (52.4%) did not take any primary aids following the ocular injury. Patient carelessness (78.1%), childhood curiosity and lack of parental supervision (11.4%), storing superglue in inappropriate places and inadvertently using superglue as eye drops due to poor vision (2.9%), inadequate awareness of superglue applications [used to stick on artificial nails (3.8%), artificial eyelashes (1.9%) and broken tooth (1%)] and being assaulted with glue (1%) were common risk factors. The frequency of ocular superglue injuries in patients referred to Farabi Eye Hospital is relatively high. This finding underlines the importance of public education and awareness about superglue injuries to the eye and taking protective measures and safety strategies in order to prevent these injures.
Meyers Valerie E
Full Text Available Abstract Background Dust exposure is a well-known occupational hazard for terrestrial workers and astronauts alike and will continue to be a concern as humankind pursues exploration and habitation of objects beyond Earth. Humankind’s limited exploration experience with the Apollo Program indicates that exposure to dust will be unavoidable. Therefore, NASA must assess potential toxicity and recommend appropriate mitigation measures to ensure that explorers are adequately protected. Visual acuity is critical during exploration activities and operations aboard spacecraft. Therefore, the present research was performed to ascertain the ocular toxicity of authentic lunar dust. Methods Small (mean particle diameter = 2.9 ± 1.0 μm, reactive lunar dust particles were produced by grinding bulk dust under ultrapure nitrogen conditions. Chemical reactivity and cytotoxicity testing were performed using the commercially available EpiOcularTM assay. Subsequent in vivo Draize testing utilized a larger size fraction of unground lunar dust that is more relevant to ocular exposures (particles Results In vitro testing indicated minimal irritancy potential based on the time required to reduce cell viability by 50% (ET50. Follow-up testing using the Draize standard protocol confirmed that the lunar dust was minimally irritating. Minor irritation of the upper eyelids was noted at the 1-hour observation point, but these effects resolved within 24 hours. In addition, no corneal scratching was observed using fluorescein stain. Conclusions Low-titanium mare lunar dust is minimally irritating to the eyes and is considered a nuisance dust for ocular exposure. No special precautions are recommended to protect against ocular exposures, but fully shielded goggles may be used if dust becomes a nuisance.
Ghasemi, Hassan; Ghazanfari, Tooba; Yaraee, Roya; Faghihzadeh, Soghrat; Hassan, Zuhair Mohammad
This review presents the current in vitro and in vivo animal and human research on the roles of IL-8 in ocular inflammatory diseases. Data sources were a literature review using Pub Med, Medline, and ISI databases (from 1990 to 2011). Search items included interleukine-8 (IL-8), CXCL8, chemokines, cytokines, alone or in combination with the, serum, aqueous, vitreous, eye, ocular, ocular tissues, ophthalmic, and review. IL-8 may be involved in primary or secondary ocular inflammations. Ocular effects of IL-8 differ based on the source of the secretion and site of the action. The most important effects of IL-8 in the eyes are angiogenic activities and induction of ocular inflammation. IL-8 plays important roles in ocular inflammation and angiogenesis in conjunctiva, cornea, iris, retina, and orbit. Anti-IL-8 targeted immunotherapy has been introduced as an important treatment modality, provided that IL-8 signal blocking takes place in desired areas and tissues.
Harris, Alon; Guidoboni, Giovanna; Arciero, Julia C; Amireskandari, Annahita; Tobe, Leslie A; Siesky, Brent A
To discuss the role of mathematical modeling in studying ocular hemodynamics, with a focus on glaucoma. We reviewed recent literature on glaucoma, ocular blood flow, autoregulation, the optic nerve head, and the use of mathematical modeling in ocular circulation. Many studies suggest that alterations in ocular hemodynamics play a significant role in the development, progression, and incidence of glaucoma. Although there is currently a limited number of studies involving mathematical modeling of ocular blood flow, regulation, and diseases (such as glaucoma), preliminary modeling work shows the potential of mathematical models to elucidate the mechanisms that contribute most significantly to glaucoma progression. Mathematical modeling is a useful tool when used synergistically with clinical and laboratory data in the study of ocular blood flow and glaucoma. The development of models to investigate the relationship between ocular hemodynamic alterations and glaucoma progression will provide a unique and useful method for studying the pathophysiology of glaucoma.
Ricardo Cardona Villa
Full Text Available El ojo es uno de los órganos más sensibles y está permanentemente expuesto a diversos agentes ambientales. Dado que la conjuntiva es un tejido inmunológicamente activo, no es sorprendente que sea un sitio común de respuestas alérgicas. Las alergias oculares son un grupo de enfermedades que afectan la superficie conjuntival y están asociadas usualmente a reacciones de hipersensibilidad tipo 1. Pueden ser divididas en varias categorías: conjuntivitis alérgica estacional, conjuntivitis alérgica perenne, queratoconjuntivitis vernal y queratoconjuntivitis atópica. La inflamación de la superficie ocular produce prurito, lagrimeo, edema conjuntival y fotofobia. Como en otras enfermedades alérgicas, se puede desarrollar una condición crónica, acompañada de remodelación de los tejidos oculares. Las estrategias para el tratamiento de la alergia ocular han aumentado exponencialmente y los clínicos disponen de un inventario cada vez mayor de agentes dirigidos a la protección del ojo contra la inflamación. En este trabajo presentamos una revisión sobre las principales formas de alergia ocular, haciendo énfasis en el cuadro clínico, el diagnóstico y las nuevas opciones terapéuticas disponibles en la actualidad. The eye, one of the most sensitive organs, is permanently exposed to different environmental agents. Since the conjunctiva is an immunologically active tissue, it is not surprising for it to be a common site for allergic responses. Ocular allergies constitute a group of diseases affecting the conjunctival surface; they are usually associated with type 1 hypersensitivity reactions. This disorder can be divided into several categories: seasonal allergic conjunctivitis, perennial allergic conjunctivitis, vernal keratoconjunctivitis and atopic keratoconjunctivitis. Ocular surface inflammation results in itching, tearing, conjunctival edema, and photophobia. As is the case with other allergic diseases, a chronic situation can also
Qi, Ying; Zhu, Yu
The aim of this study was to report the incidence and management of ocular firecracker trauma and to assess the predictive value of an Ocular Trauma Score (OTS) in ocular firecracker trauma. The study includes consecutive case study and retrospective analysis of ocular firecracker trauma. Numerical values rendered to the OTS variables (visual acuity, rupture, endophthalmitis, perforating or penetrating injury, retinal detachment, and afferent pupillary defect) at presentation were summated and converted to OTS categories. The likelihood of the final visual acuities in each category were calculated. The sensitivity and specificity of OTS were also determined. Forty-eight patients (54 eyes) were enrolled in the study. Male patients accounted for 85.4%. Of the total patients, 62.5% were younger than 15 years. Bystanders accounted for 47.9%. The average follow up was 18.5±3.6 months. The most common clinical manifestation was ocular penetrating or perforating injury. Of the total number of patients, 53.7% had best-corrected vision, at the time of their last follow up, ranging from 20/50-20/200. The OTS has 100% sensitivity and specificity to predict nonlight perception, light perception/hand motion, and 1/200-19/200. The OTS has 45% sensitivity and 100% specificity to predict vision of 20/200-20/50. The OTS has 100% sensitivity and 65% specificity to predict vision of ≥20/40. The clinical manifestations of ocular firecracker trauma in Zhengzhou are more severe than in other countries, but similar to reports of other cities of comparable size to that in China. The OTS has good predictive value for ocular firecracker trauma with 100% sensitivity and specificity to predict a final vision of nonlight perception, light perception/hand motion, and 1/200-19/200.
Meera Suresh Joshi
Full Text Available BACKGROUND In India, an estimated 1.5-2.5% children below 2 years of age are developmentally delayed. A higher incidence of ocular disability is seen in these children, refractive errors and strabismus being most common. These can add to the overall burden of health as most of them have developmental comorbidities. The aim of the study is to study the ocular disorders in children with developmental delay. MATERIALS AND METHODS We studied 112 children between the 2-12 years of age diagnosed to have developmental delay. All the subjects underwent a detailed ophthalmic evaluation including visual acuity testing using Snellen’s charts (3m and 6m and Log MAR charts (recorded as per Snellen’s vision testing to maintain uniformity, cycloplegic refraction, torchlight and slit-lamp evaluation and dilated fundus examination. The data was tabulated and represented using bar diagrams, Pie charts and graphs. The results were expressed as percentages. Design-Cross-sectional, observational study. RESULTS 66 boys and 46 girls (total 112 were evaluated. The mean age of the study population was 7.8 years ± 2.4 SD. The aetiology of developmental delay was cerebral palsy (64%, Down syndrome (22%, autism (7%, intellectual disability (4.5% and 1 case each of congenital hypothyroidism and ataxia telangiectasia. The prevalence of ocular disorders was found to be 84.8%, which was slightly higher in girls (87% as compared to boys (83%. Refractive error (79.5% was the commonest ocular disorder followed by strabismus (46.4%. Astigmatism (44.6% was the commonest refractive error, which was divided into myopic astigmatism (19.6%, hyperopic astigmatism (13.8% and mixed astigmatism (11.2%. Simple hyperopia was seen in 21.9% subjects and simple myopia in 12.1%. Exotropia (52% was commoner than esotropia (48%. Other ocular abnormalities included optic atrophy, nystagmus, epicanthal folds, cataract, mongoloid slant, ptosis, telecanthus, conjunctival telangiectasia and
Dysli, Muriel; Abegg, Mathias
Incomitance is a condition with gaze-dependent deviations of ocular alignment and is common in strabismus patients. The physiological mechanisms that maintain equal horizontal ocular alignment in all gaze directions (concomitance) in healthy individuals are poorly explored. We investigate adaptive processes in the vergence system that are induced by horizontal incomitant vergence stimuli (stimuli that require a gaze-dependent vergence response in order to re-establish binocular single vision). We measured horizontal vergence responses elicited after healthy subjects shifted their gaze from a position that required no vergence to a position that required convergence. Repetitive saccades into a position with a convergence stimulus rapidly decreased phoria (defined as the deviation of ocular alignment in the absence of a binocular stimulus). This change of phoria was present in all viewing directions (from 0° to 0.86° ± 0.40°, p vergence velocity rapidly increased (p = 0.015) and vergence latency promptly decreased (p vergence eye movements and also in pursuit-vergence eye movements. Thus, acute horizontal, gaze-dependent changes of vergence, such as may be encountered in new onset strabismus due to paralysis, can rapidly increase vergence velocity and decrease latency. Gaze-specific (concomitant) and gaze-independent (incomitant) phoria levels will adapt. These early adaptive processes increase the efficacy of binocular vision and maintain good ocular alignment in all directions of gaze.
Clare, Gerry; Suleman, Hanif; Bunce, Catey; Dua, Harminder
Ocular surface burns can be caused by chemicals (alkalis and acids) or by direct heat. Amniotic membrane transplantation (AMT) performed in the acute phase (day 0 to day 7) of an ocular surface burn is reported to relieve pain, accelerate healing and reduce scarring and blood vessel formation. The surgery involves applying a patch of amniotic membrane (AM) over the entire ocular surface up to the eyelid margins. To assess the effects of AMT on the eyes of people having suffered acute ocular surface burns. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 6), MEDLINE (January 1946 to June 2012), EMBASE (January 1980 to June 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to June 2012), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 11 June 2012. We included randomised trials of medical therapy and AMT applied in the first seven days after an ocular surface burn compared to medical therapy alone. Two authors independently assessed the risk of bias of included studies and extracted relevant data. We contacted trial investigators for missing information. We summarised data using risk ratios (RRs) and mean differences (MDs) as appropriate. We included one RCT of 100 participants with ocular burns that were randomised to treatment with AMT and medical therapy or medical therapy alone. A subset of patients (n = 68) who were treated within the first seven days of the injury met the inclusion criteria and were included in the analysis. The remaining 32 eyes were excluded. The included subset consisted of 36 moderate (Dua classification II-III) and 32 severe (Dua
Libório, Alexandre Mattoso; Nishiwaki-Dantas, Maria Cristina; Mimica, Lycia Mara Jenne; Dantas, Paulo Elias Correa; Lima, Ana Luísa Höfling de
To evaluate de presence of conjunctival aerobic microbiota in patients with ocular allergy as compared to a control group. One hundred and thirty-three patients were evaluated from April to June 2001 and divided into 2 groups. Sixty-three patients with allergic conjunctivitis (without medication) were in group A and 70 patients from the general outpatient clinic were in group B (control group). Samples from the conjunctival sac of the right eye were collected and cultured in solid media (blood, chocolate and Sabouraud agar). In group A, 30 cultures (47.7%) were positive and 6 (8.6%) in group B. Seven bacteria were isolated from group A and 4 from group B. Statistical analysis revealed significant association between positive cultures and allergic conjunctivitis. Bacterial microbiota was more frequently found in patients with ocular allergy.
E. Yu. Markovа
Full Text Available In case of viral infections, ophthalmologists, pediatricians and general practitioners should all be aware of ocular manifestations of these diseases. According to our observations, despite the presence of corneal disorders, in 95 percent of children changes were reversible and in 1.5 months visual acuity was high. Only in five percent of cases despite the intensive therapy, patients had bacterial complications, causing a decrease in visual acuity.The combined efforts of infectious disease specialists and ophthalmologists as well as timely and proper treatment are required to reduce the inflammation symptoms and prevent complications. By adding Ophtalmoferon® medication to the complex therapy of ocular surface diseases we observed its high therapeutic efficacy and a good safety profile. This medication is available in the form of ready-to-use eye drops, unlike other antiviral agents, improving its compliance in outpatients.
Kallio, H; Harju, M P; Ihanamäki, T; Vesti, E T; Kivelä, T
The intra-ocular pressure immediately before glaucoma surgery can be raised. We wished to investigate if ocular compression for 20 min before a combined peri- and retrobulbar injection would result in a lower pressure after the block. Sixty consecutive patients scheduled for filtration surgery were randomly assigned to receive ocular compression using an external pressure device for 20 min before combined peri- and retrobulbar injection (intervention group, who also received compression after the block) or to a control group in whom pressure was applied only after the block was completed. The intra-ocular pressure was measured at baseline, after the 20-min pre-injection compression (intervention group), after injecting the block, and after the 10-min post-injection compression. The pressure did not differ between groups at baseline, after the block or after the post-injection compression. In the intervention group, the compression before the block reduced the median (IQR [range]) pressure from 21.0 (17.0-25.0 [12.0-40.0]) mmHg to 16.8 (12.5-22.5 [7.5-33.5]) mmHg (pintra-ocular pressure, but applying an additional compression for 20 min before injecting the block is not beneficial. © 2011 The Authors. Anaesthesia © 2011 The Association of Anaesthetists of Great Britain and Ireland.
Sheck, Leo; Davies, Jo; Wilson, Graham
Selenium is an essential mineral and severe selenium deficiency is known to cause significant health problems. It has been well documented that New Zealand soil is low in selenium. Recent studies have addressed the roles of selenoproteins in the eyes, with evidence suggesting that selenium supplementation may have a role in preventing cataract formation and age-related maculopathy. This paper summarises the role of selenium in ocular and general health and discusses selenium supplementation in a New Zealand specific context.
Magdei, Corina; Cuşnir, Valeriu; Bârcâ, Ludmila
Epstein-Barr virus (EBV) and Citomegalovirus (CMV) are Herpesviridae family representative and presents a real danger for human. A very high infect risk of population farther the danger The ocular pathology induced by them can affect all media and tunics of optic analyzer. An etiologic differentiation is necessary for the mentioned viruses induced diseases. The etiologic differentiation has like purpose the enforcement of an effective and optimal antiviral and immunomodulating therapy.
Willerson, D; Aaberg, T M; Reeser, F; Meredith, T A
Four patients with toxoplasmosis are reported with unusual presenting ocular lesions. One patient had an active lesion that appeared to involve the optic nerve as well as focal toxoplasmosis chorioretinitis at the macula. A second patient had a pale optic nerve in association with the classical chorioretinal scars of toxoplasmosis. The third patient had toxoplasmosis chorioretinitis of the macula with subretinal neovascularisation. The fourth patient had a branch artery occlusion complicating acute retinitis. Images PMID:588525
Conclusion: Melanocytomas are small, benign tumors that are highly assessable by ocular ultrasound when their elevation surpasses 0.5 mm. In our study, the internal reflectivity ranged from high to very high, unlike other malignancies such as choroidal melanoma which tend to present with low internal reflectivity. The avascularity of the tumor is a common finding. Ultrasound is a remarkable tool that helps detect benign characteristics in a pigmented optic disk tumor and helps establish a more reliable diagnosis.
Solani D. Mathebula
Full Text Available Accumulated data supports the argument that vitamin D possesses several biological and molecular actions apart from its role in calcium absorption and facilitation of gene expression. Vitamin D deficiency has been an associated risk factor for cardiovascular disease,metabolic syndrome and ocular complications. The aim of this review is to summarise the most relevant data regarding these associations and to try to clarify whether, and to what extent, oral vitamin D supplementation could be used as a beneficial intervention in such diseases.Vitamin D is produced in skin exposed to sunlight UVB radiation and is then metabolised by the kidney into calciferol, which is an active form. The main function of vitamin D is to promote calcium and phosphorus absorption, and studies have shown that a lack of itplays an important role in ocular conditions, such as age-related macular degeneration and diabetic retinopathy. Recent studies have suggested that vitamin D may protect the diabetic retina; however, other vitamin D-associated conditions (diabetes, hypertension and cardiovascular diseases may result in secondary ocular manifestations and the potential forsight-threatening complications. The purpose of this review is to describe the current literature on the role of vitamin D in ocular and systemic wellness. However, more research is needed to determine if increasing levels of this vitamin can assist in preventing age-related macular degeneration or diabetic retinopathy. Since vitamin D is a circulating steroid hormone, its receptors are found in almost every cell in the human body, and this suggests that vitamin D might have a very broad role for overall health. However, there is still demand for further research to clarify the clinical use of vitamin D in the prevention and treatment of various chronic diseases.
Desai, P; Morris, D S; Minassian, D C; MacEwen, C J
To report trends in serious, sight-threatening ocular trauma in Scotland. A prospective, population-based, observational study of patients with ocular trauma admitted to hospital in Scotland during a 12-month period (2008-2009), conducted through the British Ophthalmic Surveillance Unit. Data on circumstances of the injuries and visual outcomes were collected using protocols standardised to those from an earlier study (1991-1992) to allow direct comparisons over time. In all, 0.3% of all emergency admissions in Scotland were for ocular trauma. Significant differences were observed between the time periods in where an injury occurred (P=0.009): a reduction of those occurring in a sports/leisure facility (8.2%) and an increase in those occurring on the street (21.4%). Assaults remained the most common cause of injury (31%). Gender differences persisted with females more likely to have an injury from falls (OR=8.67; 95% CI: 2.41-31.49; P=0.002), or in the home (OR=5.40; 95% CI: 1.69-17.16; P=0.009 ), and less likely to have one in the workplace (P=0.06). Poor visual outcome was associated with injuries occurring in the home (OR=4.33, P=0.047), in a public place (OR=6.25, P=0.047), and those caused by a fall (OR 42.75, P<0.001); or assault (OR 7.29, P=0.019). Half of those with a poor outcome have no perception of light. Serious ocular trauma remains an infrequent, sight-threatening event, associated with significant monocular visual morbidity. The findings suggest a shift from corporate to personal responsibility for risk awareness, health, and safety.
Shi, Weiyun; Wang, Ting; Gao, Hua; Xie, Lixin
To evaluate the effect of lamellar keratoplasty combined with limbal stem cells, using amniotic membrane, autologous conjunctiva, and pseudopterygium to reconstruct external eyes for severe ocular burns with symblepharon. Thirty eyes of 29 patients had severe symblephara resulting from eye burns. According to the range of the symblepharon and the loss of limbal stem cells, partial lamellar keratoplasty combined with partial limbal stem cell treatment was performed in 19 eyes, and total lamellar keratoplasty with total limbus was performed in 11 eyes. All patients had amniotic membrane and autologous conjunctival transplantation, and the pseudopterygium was preserved to reconstruct the fornix. Symblephara were completely relieved in 19 eyes. They remained partially in ten eyes in strip-like form, but seven of these were completely relieved after further autologous conjunctival transplantation. One eye was treated with tarsorrhaphy for eyelid malformation. The remaining pseudopterygium became thinner after the operation and showed no symblepharon. Immune rejection occurred in eight corneal grafts; clarity was restored in four of these, while there was graft neovascularization in the remaining four. Depending on the area of symblepharon and the loss of limbal stem cells, partial or total lamellar keratoplasty combined with limbal stem cells, using amniotic membrane, autologous conjunctiva and pseudopterygium to reconstruct external eyes appears to be effective in treating severe ocular burns with symblepharon. Pseudopterygium can partly substitute autologous conjunctiva in ocular surface reconstruction.
Riestra, A C; Alonso-Herreros, J M; Merayo-Lloves, J
The use of platelet-rich preparations has experienced a significant increase in recent years due to its role in tissue-repair and regeneration. The aim of this study is to examine the available evidence regarding the application of plasma rich in growth factors, and its variations, on the ocular surface. A review is also presented on the effects of platelet-derived growth factors, the implications of the preparation methods, and the existing literature on the safety and efficacy of these therapies in ocular surface diseases. Despite the widespread use of platelet preparations there is no consensus on the most appropriate preparation method, and growth factors concentration vary with different systems. These preparations have been used in the treatment of ocular surface diseases, such as dry eye or persistent epithelial defects, among others, with good safety and efficacy profiles, but further studies are needed to compare to the currently available alternatives. Copyright © 2016 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.
Full Text Available Ocular inflammation is one of the leading causes of blindness and loss of vision. Human uveitis is a complex and heterogeneous group of diseases characterized by inflammation of intraocular tissues. The eye may be the only organ involved, or uveitis may be part of a systemic disease. A significant number of cases are of unknown etiology and are labeled idiopathic. Animal models have been developed to the study of the physiopathogenesis of autoimmune uveitis due to the difﬁculty in obtaining human eye inflamed tissues for experiments. Most of those models are induced by injection of speciﬁc photoreceptors proteins (e.g., S-antigen, interphotoreceptor retinoid-binding protein, rhodopsin, recoverin, phosducin. Non-retinal antigens, including melanin-associated proteins and myelin basic protein, are also good inducers of uveitis in animals. Understanding the basic mechanisms and pathogenesis of autoimmune ocular diseases are essential for the development of new treatment approaches and therapeutic agents. The present review describes the main experimental models of autoimmune ocular inflammatory diseases.
Rosa María Naranjo Fernández
Full Text Available La miastenia grave es una enfermedad caracterizada por debilidad y fatiga de los músculos voluntarios debido a una trasmisión anómala a nivel de la unión neuromuscular. La prevalencia es aproximadamente de 5 casos/100 000 personas. La miastenia grave puede ser bulbar, ocular o generalizada.Existen formas clínicas en la infancia como son la miastenia neonatal transitoria, la miastenia congénita y la miastenia juvenil. Los músculos oculares, faciales y bulbares son los más frecuentes afectados por la enfermedad. Cuando los síntomas se limitan a la musculatura cercana al ojo se denomina miastenia grave ocular. Una vez el oftalmólogo diagnostica o sospecha la miastenia grave, un neurólogo generalmente dirige la comprobación y tratamiento. El papel del oftalmólogo continúa siendo importante, además de chequear la motilidad y disfunción palpebral y proporcionar el alivio sintomático para estos desórdenes, debe estar alerta a la posibilidad de ambliopía.
Harley E. A. Bicas
Full Text Available Partindo-se de um circuito esquemático relacionando os sistemas sensorial (visual binocular e oculomotor, cujos defeitos em vias aferentes ou eferentes, ou de suas interações, explicam o aparecimento dos estrabismos e suas conseqüências, são examinados os fundamentos e referenciais da movimentação ocular. Apresentam-se os conceitos de eixos e planos, centro de massa e de rotação, definem-se os movimentos monoculares de translação e de rotação e os binoculares de versões e vergências. É também referida a função dos centros de comando para movimentos voluntários e reflexos, a dos núcleos oculomotores e a respectiva inervação aos músculos oculares externos. Numa segunda parte (fisiologia da musculatura ocular extrínseca são comentadas as atividades de contração e relaxamento e a importância da lei de Sherrington. Voltando-se ao conceito de posição primária do olhar e dos referenciais das rotações, menciona-se a diversidade de vários sistemas de medidas. Em seguida, são analisadas as ações musculares rotacionais com bases no plano de ação muscular e na distribuição anatômica dos músculos, levando a resultados em posição primária do olhar e nas outras. Os efeitos de fáscias e membranas intermusculares são também comentados, terminando-se com a concepção moderna sobre as ações musculares (ação simultânea de todos os músculos em quaisquer das posições oculares. Com os condicionantes da lei de Hering, desenvolve-se o conceito de posições diagnósticas (das disfunções oculomotoras, diferentemente do clássico: os músculos são considerados em pares, de acordo às suas ações predominantes ___ horizontais (retos horizontais, verticais (retos verticais ou torcionais (oblíquos. Em cada qual devem ser comparadas as ações em condições diametralmente opostas de fixação ocular e posições do olhar (por exemplo, supradextroversão na fixação com o olho direito e infralevoversão na fixa
Lopes-Ferreira, D; Neves, H; Queiros, A; Faria-Ribeiro, M; Peixoto-de-Matos, S C; González-Méijome, J M
To show the distribution of ocular dominance as measured with sensory and eye sighting methods and its potential relationship with high and low contrast LogMAR visual acuity in presbyopic subjects. Forty-four presbyopes (48.5 ± 3.5 years) participated in this study. Ocular dominance was determined by eye sighting (hole-in-card) and sensorial (+1.50 D lens induced blur) methods. According to the dominance detected with each method (RE: right eye or LE: left eye), patients were classified in dominance type 1 (RE/RE), type 2 (RE/LE), type 3 (LE/RE) and type 4 (LE/LE). Baseline refractive error (MSE) was RE:-0.36 ± 1.67 D and LE:-0.35 ± 1.85 D (P = 0.930). RE was the dominant eye in 61.4% and 70.5% of times as obtained from sensorial and sighting methods, respectively. Most frequent dominance was of type 1 (52.3%), in this case the RE showed statistically significant better distance low contrast LogMAR VA (0.04 LogMAR units) compared to the LE (P eye sighting and sensorial methods to define ocular dominance agreed in more than half of cases. Amount of MSE was not significantly different between dominant and non-dominant eye. But in case of right dominance, the RE presented better distance low contrast VA compared to the LE.
Ishikawa, H; Liebmann, J M; Uji, Y; Ritch, R
To develop a uniform file format of ocular imaging data, including, but not limited to, ultrasound biomicroscopy, optical coherence tomography, and nerve fiber analyzer, capable of being transmitted via Internet or intranet for collaborative research and telemedicine use. File filters were developed as dynamic link libraries (DLLs). These can read the original raw data format of each ocular imaging device. A data file format was also designed to describe these raw data uniformly in three different types of compression: noncompressed, run length compression, and differential pulse code modulation (DPCM). These three file formats were then tested in the following aspects: file size, speed of reading, and speed of writing. Run length compression failed to compress raw data, while DPCM compressed raw data successfully (< or =35.5%). The speed of reading and writing files was slowest in DPCM. However, the actual time of reading and writing was fast enough (<0.6 s) for daily work regardless of file compression methods. The format designed has robust potential to be the standard file format for transmission of any ocular imaging raw data.
Full Text Available Purpose: To evaluate the demography, aetiology, type and outcome of paediatric ocular trauma in tertiary centre in Malaysia. Method: We retrospectively studied 118 eyes from 117 patients over a period of 36 months (January 2006 to December 2008. All ocular injuries in patients aged 12 and below seen in the Ophthalmology Department for the first time were included in thisstudy. Results: Mean age of patients was 6.1±3.0 years. 68 cases (58.2% occurred in pre-school children, whereas 49 (41.9% in school-aged children. Boys accounted for 65.8% of cases. There was no predilection for either right or the left eye. 47% of cases (56 patients occurred in Malay. Most of the injuries took place at home when the children were alone (p<0.05. Sharp objects were the commonest cause (45 cases, 38.1%. The majority of cases (103, 87.3% were considered preventable. The frequency of open and closed globe injury was similar. Hyphema was more common in closed globe injury compared to open globe injury (p<0.05. Other associated injuries such as cataract, vitreous hemorrhage and retinal hemorrhage are similar between the two groups. Visual outcome is generally poor with only 34 eyes (28.8% had no visual impairment. Conclusion: Ocular trauma in children is an important cause of visual loss. Most cases occurred at home and were preventable. Prevention through education is the best approach.
Mansour, A M; Bitar, F F; Traboulsi, E I; Kassak, K M; Obeid, M Y; Megarbane, A; Salti, H I
To describe the ocular findings in subjects with congenital heart disease (CHD). In a prospective study, the same observer examined 240 consecutive patients with CHD admitted to the medical centre. Two independent geneticists performed identification of syndromes. The commonest anatomic cardiac anomalies were ventricular or atrial septal defects (62), tetralogy of Fallot (39), pulmonary stenosis (25), and transposition of the great arteries (24). The heart lesions were divided physiologically into volume overload (90), cyanotic (87), and obstructive (63). In all, 105 syndromic subjects included the velocardiofacial syndrome (18), Down's syndrome (17), CHARGE association (6), DiGeorge syndrome (5), Williams syndrome (3), Edwards syndrome (3), Noonan syndrome (3), VACTERL association (2), and Patau syndrome (trisomy 13) (2). The paediatric team recognized 51 patients as syndromic. Two independent geneticists recognized additional 54 patients as syndromic. Positive eye findings were present in 55% (132) and included retinal vascular tortuosity (46), optic disc hypoplasia (30), trichomegaly (15), congenital ptosis (12), strabismus (11), retinal haemorrhages (8), prominent eyes (7), and congenital cataract (6). There was a strong correlation between the retinal vascular tortuosity and both a low haematocrit (P=0.000) and a low arterial oxygen saturation (P=0.002). Patients with CHD are at a high risk for ocular pathology and need screening for various ocular abnormalities.
A literature review of the important findings discovered over the past three decades on ocular movements during reading is presented herein. This fairly recent function in human evolution is a sophisticated sensorimotor and cognitive activity that brings very complex neurological and motor mechanisms into play. However, knowledge in this field is limited, even though reading problems are very common in children. We collected all the references in PubMed dating from 1969 to 2009 using the following "binocular coordination", "eye movements", "reading", and "dyslexia". When reading, the visual axes move in a very particular way, notably with regard to the parallelism of the ocular axes when saccades are triggered to reach the words to be read and during fixations, which enable decoding. In fact, when reading, the visual axes are often disassociated, even going as far as to intersect in a considerable number of cases. There are relatively few studies that have examined binocular coordination during reading. We are beginning to understand how the ocular axes move during horizontal saccades. Three-dimensional studies could be the next step to providing more precise data. Copyright (c) 2010 Elsevier Masson SAS. All rights reserved.
Tissue engineering (TE) is a concept that was first emerged in the early 1990s to provide solutions to severe injured tissues and/or organs . The dream was to be able to restore and replace the damaged tissue with an engineered version which would ultimately help overcome problems such as donor shortages, graft rejections, and inflammatory responses following transplantation. While an incredible amount of progress has been made, suggesting that TE concept is viable, we are still not able to overcome major obstacles. In TE, there are two main strategies that researchers have adopted: (1) cell-based, where cells are been manipulated to create their own environment before transplanted to the host, and (2) scaffold-based, where an extracellular matrix is created to mimic in vivo structures. TE approaches for ocular tissues are available and have indeed come a long way, over the last decades; however more clinically relevant ocular tissue substitutes are needed. Figure 1 highlights the importance of TE in ocular applications and indicates the avenues available based on each tissue.[...].
Vincelette, Rebecca Lee
This research was a collaborative effort between the Air Force Research Laboratory (AFRL) and the University of Texas to examine the laser-tissue interaction of thermal lensing induced by continuous-wave, CW, near-infrared, NIR, laser radiation in the eye and its influence on the formation of a retinal lesion from said radiation. CW NIR laser radiation can lead to a thermal lesion induced on the retina given sufficient power and exposure duration as related to three basic parameters; the percent of transmitted energy to, the optical absorption of, and the size of the laser-beam created at the retina. Thermal lensing is a well-known phenomenon arising from the optical absorption, and subsequent temperature rise, along the path of the propagating beam through a medium. Thermal lensing causes the laser-beam profile delivered to the retina to be time dependent. Analysis of a dual-beam, multidimensional, high-frame rate, confocal imaging system in an artificial eye determined the rate of thermal lensing in aqueous media exposed to 1110, 1130, 1150 and 1318-nm wavelengths was related to the power density created along the optical axis and linear absorption coefficient of the medium. An adaptive optics imaging system was used to record the aberrations induced by the thermal lens at the retina in an artificial eye during steady-state. Though the laser-beam profiles changed over the exposure time, the CW NIR retinal damage thresholds between 1110--1319-nm were determined to follow conventional fitting algorithms which neglected thermal lensing. A first-order mathematical model of thermal lensing was developed by conjoining an ABCD beam propagation method, Beer's law of attenuation, and a solution to the heat-equation with respect to radial diffusion. The model predicted that thermal lensing would be strongest for small (retina. The model predicted thermal lensing would cause the retinal damage threshold for wavelengths above 1300-nm to increase with decreasing beam
Athaide, Helaine Vinche Zampar; Campos, Mauro; Costa, Charles
Aging has various effects on visual system. Vision deteriorate, contrast sensitivity decreases and ocular aberrations apparently make the optical quality worse across the years. To prospective evaluate ocular aberrations along the ages. Three hundred and fifteen patients were examined, 155 were male (39.36%) and 160 were female (60.63%). Ages ranged from 5 to 64 year-old, the study was performed from February to November, 2004. Patients were divided into 4 age-groups according to IBGE (Instituto Brasileiro de Geografia e Estatística) classification: 68 patients from 5 to 14 year-old, 55 patients from 15 to 24 year-old, 116 from 25 to 44 year-old and 76 from 45 to 67 year-old. All patients had the following characteristics: best corrected visual acuity > 20/25, emmetropia or spherical equivalent < 3.50 SD, refractive astigmatism < 1.75 CD on cycloplegic refraction, normal ophthalmologic exam and no previous ocular surgeries. This protocol was approved by Federal University of São Paulo Institutional Review Board. Total optical aberrations were measured by H-S sensor LadarWave Custom Cornea Wavefront System (Alcon Laboratories Inc, Orlando, FLA, USA) and were statistically analysed. Corneal aberrations were calculated using CT-View software Version 6.89 (Sarver and Associates, Celebration, FL, USA). Lens aberrations were calculated by subtraction. High-order (0.32 e 0.48 microm) and ocular spherical aberrations (0.02 e 0.26 microm) increased respectively in child and middle age groups. High order (0.27 microm) and corneal spherical aberrations (0.05 microm) did not show changes with age. Lens showed a statistically significant spherical aberration increase (from -0.02 to 0.22 microm). Vertical (from 0.10 to -0.07 microm) and horizontal coma (from 0.01 to -0.12 microm) presented progressively negative values with aging. High-order and spherical aberrations increased with age due to lens contribution. The cornea did not affect significantly changes observed on ocular
Pahk, Patricia J; Adelman, Ron A
Paintball-related ocular injuries result in severe damage and loss of vision. Despite efforts to increase public awareness and improve safety features, the incidence of eye injuries has increased over time. We examined the characteristics and ocular effects of paintball injury at our tertiary referral center. Retrospective review of charts of patients with paintball injury between 1998-2005. Fourteen patients were evaluated for paintball injury; 13 (93%) were male and one (7%) was female. Average age was 17 years (range from 9 to 30). Thirteen patients (95%) did not wear eye protection; one is unknown. Injuries occurred while playing paintball in three patients (21%); ten (71%) were injured in either accidental (four patients) or intentional (six patients) shootings not associated with play. Minimum follow-up was 6 weeks, except for one patient who was lost to follow-up. Seven patients (50%) had final visual acuity (VA) better than 20/200, six patients (43%) were 20/200 or worse, and information on one patient was not available. VA, except in one case, improved with treatment. Decreased VA in this case was due to proliferative vitreoretinopathy (PVR). Hyphema was noted in ten patients (71%), vitreous hemorrhage in eight (57%), retinal hemorrhage in six (43%), retinal tear or detachment in six (43%), commotio retinae in six (43%), iris injury in five (36%), keratopathy in four (29%), lens injury in two (14%), subluxation of lens in two (14%), secondary glaucoma in two (14%), open globe/intraocular foreign body (IOFB) in one (7%), choroidal rupture in one (7%), and proliferative vitreoretinopathy (PVR) in one (7%). Ten patients (71%) required intervention (surgery, laser retinopexy or cryotherapy). Paintball trauma results in significant ocular injury and loss of vision. Most injuries occur in unsupervised settings without proper eye protection. Ten patients (71%) were injured in accidental or intentional shootings. Lack of supervision and use of paintball materials
Zhang, Xiaobo; Jeyalatha M, Vimalin; Qu, Yangluowa; He, Xin; Ou, Shangkun; Bu, Jinghua; Jia, Changkai; Wang, Junqi; Wu, Han; Liu, Zuguo
Dry eye can damage the ocular surface and result in mild corneal epithelial defect to blinding corneal pannus formation and squamous metaplasia. Significant progress in the treatment of dry eye has been made in the last two decades; progressing from lubricating and hydrating the ocular surface with artificial tear to stimulating tear secretion; anti-inflammation and immune regulation. With the increase in knowledge regarding the pathophysiology of dry eye, we propose in this review the concept of ocular surface microenvironment. Various components of the microenvironment contribute to the homeostasis of ocular surface. Compromise in one or more components can result in homeostasis disruption of ocular surface leading to dry eye disease. Complete evaluation of the microenvironment component changes in dry eye patients will not only lead to appropriate diagnosis, but also guide in timely and effective clinical management. Successful treatment of dry eye should be aimed to restore the homeostasis of the ocular surface microenvironment. PMID:28661456
Ghasemi, Hassan; Ghazanfari, Tooba; Yaraee, Roya; Owlia, Parviz; Hassan, Zuhair Mohammad; Faghihzadeh, Soghrat
This review represents the current in vitro, in vivo, animal and human investigations on the roles of IL-10 in ocular inflammatory conditions. The data sources were literature reviews, including Pub Med, Medline, and ISI databases (since 1989 to mid-2012). Search items were, IL-10, chemokines, cytokines, alone or in combination with, serum, aqueous, vitreous eye, ocular, ocular tissues, ophthalmic, and review. Ocular effects of IL-10 depend on the sources of the secretion and sites of the action. IL-10 plays important anti-inflammatory and especially anti-angiogenic activities in ocular tissues such as the conjunctiva, cornea, retina, choroid, and orbit. IL-10 plays major anti-inflammatory and anti-angiogenic roles in most of the ocular inflammations. Also, IL-10 plays a role in development of anterior chamber-associated immune deviation (ACAID). Any manipulation of IL-10 for treatment purposes should be considered very cautiously due to its potential hazards to the immune system.
Ana Carolina Cabreira Vieira
Full Text Available Rosacea is a prevalent chronic cutaneous disorder with variable presentation and severity. Although considered a skin disease, rosacea may evolve the eyes in 58-72% of the patients, causing eyelid and ocular surface inflammation. About one third of the patients develop potentially sight-threatening corneal involvement. Untreated rosacea may cause varying degrees of ocular morbidity. The importance of early diagnosis and adequate treatment cannot be overemphasized. There is not yet a diagnostic test for rosacea. The diagnosis of ocular rosacea relies on observation of clinical features, which can be challenging in up to 90% of patients in whom accompanying roseatic skin changes may be subtle or inexistent. In this review, we describe the pathophysiologic mechanisms proposed in the literature, clinical features, diagnosis and management of ocular rosacea, as well as discuss the need for a diagnostic test for the disease.A rosácea é uma condição cutânea crônica, que possui apresentações clínicas variáveis. Apesar de considerada uma doença dermatológica, os olhos podem ser acometidos em 58-72% dos casos, causando inflamação palpebral e da superfície ocular. Aproximadamente um terço dos pacientes desenvolve acometimento corneano, podendo causar baixa visual significativa. Diagnóstico precoce e tratamento adequado são de extrema importância, devido à significativa morbidade ocular que a doença pode causar. Não há, até o momento, um teste diagnóstico para rosácea. O diagnóstico da rosácea ocular depende da observação das manifestações clínicas, o que pode ser bastante desafiador em até 90% dos pacientes, em que os achados cutâneos são discretos ou inexistentes. Nesta revisão, descrevemos os mecanismos fisiopatológicos propostos na literatura, manifestações clínicas, diagnóstico e tratamento da rosácea ocular, assim como abordamos a necessidade de um teste diagnóstico.
Burns to the sclera, conjunctiva, cornea, and eyelid are considered ocular burns. Ocular burn injuries are classified by etiologic agents as either chemical injuries (ie, acid, alkali) or radiant energy injuries (ie, thermal, ultraviolet). Chemical injuries to the eye represent one of the true ophthalmic emergencies. While almost any chemical can cause ocular irritation, serious damage generally results from either strongly basic (alkaline) compounds or acidic compounds. Alkali injuries are m...
Al-Amry, Mohammad; Al-Ghadeer, Huda
Paintball is a popular recreational sport. This case series describes three Saudi patients exposed to paintball ocular injuries with sever ocular trauma. Two patients developed hyphema and traumatic cataract and one patient had vitreous hemorrhage, choroidal detachment, commotio retinae and retinal tear. All patients require surgical intervention. Final best corrected visual acuity was 20/200, 20/30 and 20/50 respectively. Paintball related ocular injuries can result in severe visual loss and...
Mizoguchi, Shin; Iwanishi, Hiroki; Arita, Reiko; Shirai, Kumi; Sumioka, Takayoshi; Kokado, Masahide; Jester, James V; Saika, Shizuya
Dysfunction of the meibomian glands alters secreted meibum quantitatively and qualitatively that can lead to damage to the ocular surface epithelium. In response to an unstable tear film cause by meibomian gland dysfunction, ocular surface epithelium is damaged and expresses inflammatory cytokines leading to secondary ocular inflammation. In turn, inflammatory disorders of the palpebral conjunctiva and lid margin may affect the structure and function of meibomian gland. The disorders include allergic conjunctivitis, long-term usage of contact lenses, dermatological diseases that affect conjunctival homeostasis, Stevens-Johnson's syndrome or chemical burning of the ocular surface and lid margin. Copyright © 2017. Published by Elsevier Ltd.
Hertle, Richard W
The purpose of this report is to summarize an understanding of the ocular motor system in patients with albinism. Other than the association of vertical eccentric gaze null positions and asymmetric, (a) periodic alternating nystagmus in a large percentage of patients, the ocular motor system in human albinism does not contain unique pathology, rather has "typical" types of infantile ocular oscillations and binocular disorders. Both the ocular motor and afferent visual system are affected to varying degrees in patients with albinism, thus, combined treatment of both systems will maximize visual function.
Kontrovitz, M.; Puckett, T.M.
This is the first study of internal ocular shell structures of Cretaceous ostracodes. Internal molds from eight species of four genera from Santonian, Campanian, and Maastrichtian strata revealed a stalked ocular sinus constricted along its length and distally inflated. The latter part has anterior and posterior lobes and a subcentral concavity. These Cretaceous trachyleberids have ocular shell structures similar to Cenozoic taxa and it is presumed they functioned similarly. However, each taxon has a diagnostic ocular sinus and an inner surface of the eye tubercle that distinguishes each from all other forms examined.
Kim, Joowon; Hwang, Yunji; Kang, Seungheon; Kim, Minhye; Kim, Tae-Shin; Kim, Jay; Seo, Jeongmin; Ahn, Hyojeong; Yoon, Sungjoon; Yun, Jun Pil; Lee, Yae Lim; Ham, Hyunsoo; Yu, Hyeong Gon; Park, Sue K
Smartphone use has dramatically increased in recent years. Smartphones may have adverse health effects, particularly on the eyes, because users stare at the screen for a much longer time than they do with ordinary mobile phones. The objective of this study was to elucidate the relationship between smartphone use and ocular symptoms among adolescents. Information on smartphone use and ocular symptoms (blurring, redness, visual disturbance, secretion, inflammation, lacrimation and dryness) related to eye fatigue and strain from 715 adolescent subjects from three cities in Korea was obtained using a structured questionnaire. Ocular health was scored using number of ocular symptoms. Odds ratios (ORs), 95% confidence intervals (95% CIs) and p-values for ocular symptoms were calculated with binomial and multinomial logistic regression models. Higher prevalence rates for ocular symptoms were observed in groups with greater exposure to smartphones (p smartphone use was associated with a higher likelihood of having multiple ocular symptoms (5-7 symptoms out of 7 symptoms; p = 0.005). Excessive/intermittent use (>2 hours daily and ≤2 hours continuously) and excessive/persistent use (>2 hours daily and >2 hours continuously) compared to shorter use (smartphones was associated with a higher likelihood of having multiple ocular symptoms (OR 3.05, 95% CI 1.51-6.19; p = 0.001). Increasing exposure to smartphones can have a negative impact on ocular health in adolescents.
Full Text Available Joanna DaCostaMoorfields Eye Hospital, London, UKAbstract: Conjunctivitis is often considered an innocuous condition which is self-limiting. This report describes misdiagnosis of ocular cicatricial pemphigoid as chronic conjunctivitis. Ocular cicatricial pemphigoid is a rare autoimmune condition. The clinical features which are useful to distinguish this condition from infective conjunctivitis are discussed. The investigation and treatment of ocular cicatricial pemphigoid is discussed. It is important to recognize nonocular symptoms and signs that may indicate the presence of a more serious underlying pathological condition necessitating specialized ophthalmic referral and subsequent investigation and treatment.Keywords: autoimmune, conjunctivitis, ocular cicatricial pemphigoid
Kofoed, Peter Kristian; Munch, Inger Christine; Larsen, Michael
Abstract. Purpose: To report the result of ranibizumab administration in an eye with ocular ischaemic syndrome. Methods: Fluorescein angiography, ocular pneumoplethysmography and retinal vessel calibre measurement. Results: An 85-year-old man with ocular ischaemic syndrome demonstrated vision los...
Anastasopoulos, D; Haslwanter, T; Fetter, M; Dichgans, J
Horizontal and vertical smooth pursuit was compared with otolith-ocular responses in 11 patients with cerebellar ataxia and 21 normal subjects using three-dimensional magnetic search coil eye movement recordings. Otolith-ocular responses were investigated during off-vertical axis rotation. This stimulus induces nystagmus consisting of the exponentially decaying canalicular response, and an eye-velocity modulation and offset which arise from the excitation of the otoliths by the gravity vector, which lasts as long as the rotation continues. Otolith-ocular reflexes are intimately interrelated with visual tracking when real targets are viewed during linear motion. The responses of both the translational vestibulo-ocular reflex and the pursuit system have been shown to be linearly dependent on the inverse of the viewing distance, so that a common central pathway for the two systems has been suggested, probably travelling through the cerebellum. Thus, the aim of the study was to evaluate to what extent these reflexes are disturbed in cerebellar disease. The results confirm the earlier notion that in normal subjects pursuit performance is better for horizontal than for vertical tracking, and that it is better for upward than for downward tracking. This pattern is also found in patients. In addition, smooth pursuit performance is clearly degraded in patients, but the modulation of eye-velocity during off-vertical axis rotation is enhanced. Since the amount of this enhancement does not correlate with the amount of pursuit impairment, degradation of smooth pursuit and pathological enhancement of otolith-ocular responses seem to be independent effects of cerebellar degeneration. Thus, the increase in the otolith-ocular response in patients cannot be attributed to adaptational mechanisms trying to overcome the smooth pursuit deficiency; it is more likely to represent pathological disinhibition of otolith derived responses. The absence of compensatory eye-velocity offset
Marilita M. Moschos
Full Text Available The aim of this manuscript is to review the action and adverse effects of combined oral contraceptives (COCs on ocular tissues. The percentage of unwanted pregnancies and the subsequent abortions make contraception crucial worldwide. Over 100 million women around the world use common contraceptive methods, including intrauterine devices, combined estrogen and progestin oral contraceptives, as well as progestin only preparations (oral contraceptives, implants or injections. COCs are widely used for contraception, but they are also indicated in menorrhagia, endometriosis, acne and hirsutism, fibroid uterus and premenstrual syndrome. However, they have been associated with high rates of cardiovascular events, venous thromboembolic disease, ischemic strokes and breast cancer. The incidence of COCs-related ocular complications is estimated to be 1 in 230 000, including dry eye symptoms, corneal edema, lens opacities and retinal neuro-ophthalmologic or vascular complications. We may infer that the serious ocular complications of COCs can be prevented by eliminating the estrogen dosage and choosing third-generation progestins. In any case, doctors should take into consideration the systemic and ocular history of the patients before selecting any method of contraception.
Rydberg, A; Ygge, J; Olsson, M
To assess the ocular motor functions in children with spastic hemiplegia by using the Ocular Motor Score (OMS). This study included 34 children, median age 11 years. The children were divided into 3 groups according to the underlying brain lesion; group 1 malformations, group 2 white matter damage of immaturity (WMDI), and group 3 cortical/subcortical lesions. The OMS protocol consists of 15 different subtests evaluating ocular motor functions. The OMS is divided into 2 parts, a static and a dynamic. The results from each subtest are scored 0, 0.3, 0.5, or 1, according to the level of disturbance, where 0 corresponds to normal function and 1 represents the maximum disability in the certain subtest. A total OMS (tOMS) between 0 and 15 can be obtained. The median tOMS in the whole spastic hemiplegia group was 2.5 (range 1.3-5.8). The highest median tOMS 5.2 was seen in group 1, in the children with malformations. Strabismus was found in 45% (15/34) of the children, with an equal percentage in all 3 groups. The children with spastic hemiplegia had a median tOMS of 2.7 and the highest median tOMS was seen in children with malformations. The OMS protocol is easy to use clinically and gives a quick overview of the patient´s ocular motor functions.
Eduardo Ariel Ramos Gómez
Full Text Available La rehabilitación en oftalmología tiene como función fundamental lograr el máximo aprovechamiento posible del resto visual. El traumatismo ocular es considerado una de las entidades nosológicas frecuentes que conllevan a una rehabilitación visual. Las causas que provocan este tipo de trauma son variadas y dentro de estas, las agresiones con intención de provocar daños con secuelas son muy frecuentes. Es objetivo de esta revisión puntualizar la importancia de la rehabilitación en pacientes con traumatismo ocular e incentivar el buen accionar de todos los oftalmólogos en cuanto a su atención.The main goal of rehabilitation in ophthalmology is to use as much as possible the residual vision. Ocular trauma is considered one of the common diseases that imply visual rehabilitation. The causes of eye injuries are varied; among them assaults with intent to cause damage are the most common. The objective of this article was to point out the importance of rehabilitation in patients with ocular trauma and to encourage all the ophthalmologists to act accordingly.
Lin, Michelle P; Ekşioğlu, Ümit; Mudumbai, Raghu C; Slabaugh, Mark A; Chen, Philip P
To examine the development and management of glaucoma in patients with ocular chemical burns. Retrospective, observational case series. setting: University of Washington Eye Clinics. patient population: Twenty-nine eyes (18 patients) with ocular chemical burns seen between 1997 and 2010 with a minimum of 3 months of follow-up. observation procedure: Eyes were graded using the Roper-Hall scale. main outcome measures: Long-term use of glaucoma medications (3 months or more) and need for glaucoma surgery. The mean age was 45 ± 17 years, with a mean follow-up of 75 ± 47 months (median, 66 months). Roper-Hall grade III or IV eyes (n = 20) had significantly higher intraocular pressure at presentation (35.9 vs 16.4 mm Hg; P = .001) and over follow-up were more likely to require long-term glaucoma medications (P = .003) or to undergo glaucoma surgery (P = .016) than Roper-Hall grade I or II eyes. Thirteen eyes (12 Roper-Hall grade III or IV) underwent glaucoma surgery. Eight eyes underwent glaucoma tube implant surgery; 4 required at least 1 revision. Seven eyes underwent diode laser cyclophotocoagulation; 4 required repeat treatment. Most (89%) eyes had controlled intraocular pressure at the last follow-up. However, 76% of eyes with visual acuity of 20/200 or worse at initial evaluation did not have improved vision at the last follow-up. Eyes with Roper-Hall grade III or IV ocular chemical burns were more likely to have glaucoma and to require surgery for it. Outcomes of glaucoma management generally were good, although tube implant surgeries often had complications requiring revision. Copyright © 2012 Elsevier Inc. All rights reserved.
Huang, Hu; Vasilakis, Panagiotis; Zhong, Xiufeng; Shen, Ji-Kui; Geronatsiou, Katerina; Papadaki, Helen; Maragoudakis, Michael E.; Gartaganis, Sotirios P.; Vinores, Stanley A.
Purpose. Parstatin is a 41-mer peptide formed by proteolytic cleavage on activation of the PAR1 receptor. The authors recently showed that parstatin is a potent inhibitor of angiogenesis. The purpose of the present study was to evaluate the therapeutic effect of parstatin on ocular neovascularization. Methods. Choroidal neovascularization was generated in mice using laser-induced rupture of Bruch's membrane and was assessed after 14 days after perfusion of FITC-dextran. Oxygen-induced retinal neovascularization was established in neonatal mice by exposing them to 75% O2 at postnatal day (P)7 for 5 days and then placing them in room air for 5 days. Evaluation was performed on P17 after staining with anti-mouse PECAM-1. The effect of parstatin was tested after intravitreal administration. The effects of subconjunctival-injected parstatin on corneal neovascularization and inflammation in rats were assessed 7 days after chemical burn-induced corneal neovascularization. Retinal leukostasis in mice was assessed after perfusion with FITC-conjugated concanavalin A. Results. Parstatin potently inhibited choroidal neovascularization with an IC50 of approximately 3 μg and a maximum inhibition of 59% at 10 μg. Parstatin suppressed retinal neovascularization with maximum inhibition of 60% at 3 μg. Ten-microgram and 30-μg doses appeared to be toxic to the neonatal retina. Subconjunctival parstatin inhibited corneal neovascularization, with 200 μg the most effective dose (59% inhibition). In addition, parstatin significantly inhibited corneal inflammation and VEGF-induced retinal leukostasis. In all models tested, scrambled parstatin was without any significant effect. Conclusions. Parstatin is a potent antiangiogenic agent of ocular neovascularization and may have clinical potential in the treatment of angiogenesis-related ocular disorders. PMID:20538980
Full Text Available Purpose. To show the distribution of ocular dominance as measured with sensory and eye sighting methods and its potential relationship with high and low contrast LogMAR visual acuity in presbyopic subjects. Method. Forty-four presbyopes (48.5 ± 3.5 years participated in this study. Ocular dominance was determined by eye sighting (hole-in-card and sensorial (+1.50 D lens induced blur methods. According to the dominance detected with each method (RE: right eye or LE: left eye, patients were classified in dominance type 1 (RE/RE, type 2 (RE/LE, type 3 (LE/RE and type 4 (LE/LE. Results. Baseline refractive error (MSE was RE:−0.36 ± 1.67 D and LE:−0.35 ± 1.85 D (P=0.930. RE was the dominant eye in 61.4% and 70.5% of times as obtained from sensorial and sighting methods, respectively. Most frequent dominance was of type 1 (52.3%, in this case the RE showed statistically significant better distance low contrast LogMAR VA (0.04 LogMAR units compared to the LE (P<0.05. Conclusions. The dominance was more frequent in RE in this sample. The eye sighting and sensorial methods to define ocular dominance agreed in more than half of cases. Amount of MSE was not significantly different between dominant and non-dominant eye. But in case of right dominance, the RE presented better distance low contrast VA compared to the LE.
Salvo, M; Pinna, A; Milia, P; Carta, F
Münchausen syndrome is a factitious disorder in which patients knowingly harm themselves for subconscious psychological reasons in order to be hospitalized. Recognition of this psychopathology is important, to prevent potentially severe eye damage. Ocular Münchausen syndrome is uncommon. The authors describe an elderly woman with recurrent, probably self-induced, ocular trauma leading to bilateral blindness. The authors are unaware of any previously reported cases of Münchausen syndrome resulting in bilateral blindness and occurring in old age. A 73-year-old woman was first seen in 1991 with a closed-globe injury to the right eye, apparently following a household fall. Physical examination showed no sign of extraocular trauma. Right visual acuity was 20/30 after 2 months. She was readmitted in May 2003 with left globe rupture, allegedly following a domestic fall. No extraocular trauma was found. She developed ocular phthisis 6 months postoperatively. The patient was admitted again in February 2004 with right globe rupture, following another alleged domestic fall. Physical examination showed no sign of extraocular trauma. Right visual acuity was 20/400 2 months postoperatively. Psychiatric evaluation revealed Münchausen syndrome. Psychotherapy was prescribed, but refused by her family. Diagnosis of Münchausen syndrome is difficult to make in the ophthalmic department. Münchausen patients have little or no ability to control their self-destructive behavior. A sympathetic and supportive approach is therefore required and these patients should be urgently referred to a psychiatrist with experience in factitious disorders. Even with psychotherapy, which is often refused, the prognosis remains poor.
Full Text Available Background - Ocular surface disorders due to limbal stem cell deficiency are an important cause of ocular morbidity and visual loss. Although autologous limbal stem cell transplants have helped in the management of unilateral disease, allografts in those with bilateral disease often fail due to immunological reasons. The use of autologous buccal epithelium cultivated on amniotic membrane has been described as a useful approach in the management of this condition. It is the purpose of this study to explore the feasibility of using a novel thermo-gelatin polymer (TGP as a substrate to culture these cells, and to characterize them using RNA extraction and RT-PCR. Methods - Oral cheek mucosal biopsies were obtained from 5 adult patients undergoing Modified Osteo-Odonto Keratoprosthesis surgery. The specimens were transported to the laboratory in transport medium. The cells were released using enzymatic digestion and seeded in both convention culture medium and TGP. The resulting cellular growth was characterized using RNA extraction and RT-PCR. Results - Cells could be cultured from 4 of the 5 specimens. In one specimen, contamination occurred and this was discarded. In the other specimens, the cheek epithelial cells could be cultured in both the conventional culture medium and TGP, with equal ease. RT-PCR revealed the presence of K3, a marker for epithelial cells, and GAPDH indicating the presence of some adipose tissue as well. Conclusions - It is possible to culture autologous cheek mucosal epithelial cells using TGP, a synthetic scaffold, without the need for other biological substrates. Since the specimens are obtained from the oral cavity, stringent asepsis is required. Further studies are required for histopathological characterization of the cultured cells and to create a model for delivery onto the ocular surface of eyes with bilateral surface disease due to limbal stem cell deficiency.
Laties, A M; Fraunfelder, F T
To date, sildenafil citrate (Viagra) gives every evidence of being a safe drug for the eye despite a series of expressed concerns. A review of how its ocular safety profile has been identified offers insights into the strengths and weaknesses of present systems and resources for judging the ocular safety of Viagra or, for that matter, of any new drug. Such insights include: The great value of careful, informed assessment of preclinical information gleaned from laboratory experiments. By and large, such assessments point the way toward appropriate clinical evaluation. For Viagra, early in its development it was noted that besides exerting a major inhibitory effect on the intended target, the vascular-associated enzyme phosphodiesterase 5 (PDE5), the drug also exerts a lesser but definite inhibitory effect on the closely related PDE6, located in the retina. For this reason, preclinical evaluation of the drug included electroretinography plus postmortem histology. In addition, an extended eye examination was incorporated into clinical protocols. The often chaotic but invaluable information stream that becomes available once marketing approval has been gained and large populations begin to use a drug. False alarms, misattribution, and erroneous information are the order of the day. Nevertheless, as information accumulates, patterns of response clarify and the true nature of special susceptibility for subpopulations, if any, becomes apparent. A role for the astute clinician remains: Subtle changes or unusual risks for subpopulations can be missed entirely for long periods of time. A manifest need for improvement in evaluation of postmarketing side-effects. This need has led to the establishment of a new discipline: pharmacoepidemiology. In ophthalmology, the National Registry of Drug Induced Ocular Side-Effects maintains a constant and invaluable surveillance. Examples are supplied to illustrate each of these major points: Our presentation will include data gleaned from
Full Text Available Subramaniam Suresh1, Saidin Nor-Masniwati1, Muhd Nor Nor-Idahriani1, Wan-Hitam Wan-Hazabbah1, Mohamed Zeehaida2, Embong Zunaina11Department of Ophthalmology, 2Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, MalaysiaBackground: The purpose of this study was to evaluate the immunoglobulin (Ig G avidity of serological toxoplasmosis testing in patients with ocular inflammation and to determine the clinical manifestations of ocular toxoplasmosis.Methods: A retrospective review of all patients presenting with ocular inflammation to the Hospital Universiti Sains Malaysia, Kelantan, Malaysia between 2005 and 2009 was undertaken. Visual acuity, clinical manifestations at presentation, toxoplasmosis antibody testing, and treatment records were analyzed.Results: A total of 130 patients with ocular inflammation were reviewed retrospectively. The patients had a mean age of 38.41 (standard deviation 19.24, range 6–83 years. Seventy-one patients (54.6% were found to be seropositive, of whom five (3.8% were both IgG and IgM positive (suggestive of recently acquired ocular toxoplasmosis while one (0.8% showed IgG avidity ≤40% (suggestive of recently acquired ocular toxoplasmosis and 65 patients (50.0% showed IgG avidity >40% (suggestive of reactivation of toxoplasmosis infection. Chorioretinal scarring as an ocular manifestation was significantly more common in patients with seropositive toxoplasmosis (P = 0.036. Eighteen patients (13.8% were diagnosed as having recent and/or active ocular toxoplasmosis based on clinical manifestations and serological testing.Conclusion: Ocular toxoplasmosis is a clinical diagnosis, but specific toxoplasmosis antibody testing helps to support the diagnosis and to differentiate between reactivation of infection and recently acquired ocular toxoplasmosis.Keywords: ocular toxoplasmosis, chorioretinal scar, toxoplasmosis antibody, IgG avidity test
Vital Paulino Costa
Full Text Available PURPOSE: To examine the prevalence of ocular surface complaints in Brazilian patients with glaucoma or ocular hypertension who used topical intraocular pressure (IOP-lowering regimens. METHODS: In this multicenter, noninterventional, single-visit study, adults with glaucoma or ocular hypertension treated with an IOP-lowering regimen were administered the 12-item ocular surface disease index (OSDI questionnaire. Each response was scored on a 5-point scale, with 0 indicating symptom present none of the time and 4 indicating symptom present all of the time. The average of the 12 item responses for each patient was transformed to a scale from 0 to 100, with higher scores representing worse disabilities. OSDI results then were categorized as absence of OSD (scores of 0-12, mild OSD (scores of 13-22, moderate OSD (scores of 23-32, or severe OSD (scores of 33100. RESULTS: The 173 enrolled patients had a mean age of 61.2 years, were women in 65.3% of cases, and had glaucoma in 89.0% of cases and ocular hypertension in 11.0% of cases. OSDI scores for 158 patients using 1 IOP-lowering therapy indicated no OSD in 37.3% of patients (59/158, mild OSD in 20.9% (33/158, moderate OSD in 17.1% (27/158, and severe OSD in 24.7% (39/158. For the 120 patients using 1 IOP-lowering medication and having a known duration of diagnosis of glaucoma or ocular hypertension, mean OSDI scores were numerically higher (worse for the 39 patients with a diagnosis ≥6 years long (score 25 [± 20], indicating moderate OSD than for the 81 patients with a diagnosis lasting <6 years (score 22 [± 20], indicating mild OSD; however, no significant differences in OSDI scores by duration of diagnosis were evident in means (P=0.49, distributions (P≥0.26, or correlation (P=0.77. CONCLUSIONS: A large proportion of Brazilian patients treated with 1 IOP-lowering therapy had some ocular surface complaints.
Jurja, Sanda; Hîncu, Mihaela; Dobrescu, Mihaela Amelia; Golu, Andreea Elena; Bălăşoiu, Andrei Theodor; Coman, Mălina
Vision is based on the sensitivity of the eye to visible rays of the solar spectrum, which allows the recording and transfer of visual information by photoelectric reaction. Any electromagnetic radiation, if sufficiently intense, may cause damages in living tissues. In a changing environment, the aim of this paper is to point out the impact of light radiation on ocular cells, with its phototoxicity potential on eye tissues. In fact, faced with light and oxygen, the eye behaves like an ephemeral aggregate of unstable molecules, like a temporary crystallization threatened with entropia.
Cadera, W; Viirre, E; Karlik, S
We describe a technique of generation of a cine motion picture of ocular movements in a patient with Duane Type II exotropia. With the magnetic resonance scanning unit, multiple scans can be sequenced to give a graphic animation to the eyes as targets are fixated across the visual field. With this technique, we were able to clearly view the contractility of the extraocular muscles and note the changes in pulling directions of the muscles in this patient. The restriction of movement due to the cocontraction of the horizontal rectus muscles was readily apparent.
Spokes, David; Siddiqui, Salina; Vize, Colin
The case is presented of a 12-year old boy who sustained severe penetrating ocular trauma while playing on a domestic trampoline. A main spring broke under tension and the hook had struck the eye at high velocity and penetrated the sclera. Primary repair was undertaken but on review it became apparent the eye could not be salvaged. Evisceration was carried out and an orbital implant was placed. Post-operative cosmesis is acceptable. This type of injury has not been reported before. Adult supervision of children on trampolines is recommended to minimise the chance of serious injury.
Alexandre Mattoso Libório; Maria Cristina Nishiwaki-Dantas; Lycia Mara Jenne Mimica; Paulo Elias Correa Dantas; Ana Luísa Höfling de Lima
OBJETIVO: Avaliar a presença de microbiota aeróbia da conjuntiva de portadores de alergia ocular e comparar a um grupo controle. MÉTODOS: Foram examinados 133 pacientes no período de abril a junho de 2001 divididos em 2 grupos. O grupo A foi composto de 63 portadores de conjuntivite alérgica (sem uso de medicação) e o grupo B de 70 pacientes do ambulatório geral (controle). Foram coletadas amostras do fundo de saco conjuntival do olho direito de todos os pacientes e o material foi semeado em ...
Harmening, Wolf M; Vobig, Michael A; Walter, Peter; Wagner, Hermann
Optical quality in barn owl eyes is presented in terms of measuring the ocular wavefront aberrations with a standard Tscherning-type wavefront aberrometer under natural viewing conditions. While accommodative state was uncontrolled, all eyes were focused within 0.4D with respect to the plane of the aberrometer. Total RMS wavefront error was between 0.06 and 0.15 microm (mean: 0.10 microm, STD: 0.03 microm, defocus cancelled) for a 6 mm pupil. The results suggest that image quality in barn owl eyes is excellent.
Retinal involvement in systemic lupus erythematosus is dominated by a microangiopathy of unknown aetiology, with occlusive consequences. Although cases of severe retinal ischaemia have been recently described, from a statistic point of view, the occlusive phenomena seem to have declined over the last decades, under the influence of a better therapy and follow-up of the disease. The relatively high incidence of papilloedema and the fact that this oedema might be unilateral or asymptomatic are pointed out. The importance of ophthalmic examination in patients with SLE-like syndromes or in seronegative cases of SLE is revealed. Other ocular manifestation of the disease are reviewed.
Sethi, Tania; Kheur, Mohit; Haylock, Colin; Harianawala, Husain
Defects of the eye may follow removal of a part of or the entire orbit. This results in the patient becoming visually, esthetically and psychologically handicapped. Restoring the defect with a silicone- or acrylic-based prosthesis not only restores esthetics but also gives back the lost confidence to the patient. This is a case report of a patient with a 'pthisical eye' and details the steps in fabrication of an ocular prosthesis. Particular attention has been given to the laboratory process in this technique to minimize the residual monomer content in the artificial eye.
Moergeli, J R; Fraleigh, E M; Ostrowski, J S; Pelleu, G B
Two ophthalmic and two dental irreversible hydrocolloid materials were tested on rabbit conjunctivae to determine histologically their potential to irritate these tissues. Each of the four impression materials elicited nearly the same amount of inflammatory response. The differences between the response of the controls and the response to Ophthalmic Mold-Eye, Jelset Special Formula, and Kerr Alignate Type II were significant. These results indicate that certain dental irreversible hydrocolloids may be used for ocular prostheses but that they should be used with caution because of the inflammation caused by irreversible hydrocolloids.
Full Text Available The human body harbors within it an intricate and delicate balance between oxidants and antioxidants. Any disruption in this checks-and-balances system can lead to harmful consequences in various organs and tissues, such as the eye. This review focuses on the effects of oxidative stress and the role of a particular antioxidant system—the Keap1-Nrf2-ARE pathway—on ocular diseases, specifically age-related macular degeneration, cataracts, diabetic retinopathy, and glaucoma. Together, they are the major causes of blindness in the world.
Greven, Craig M; Bashinsky, Alice L
To determine the circumstance and outcome of ocular injuries attributable to paintball projectiles. Retrospective interventional case series. Institutional review board approved retrospective chart review of 19 consecutive eyes with paintball injuries with minimum follow-up of 3 months. Ten eyes (53%) had final visual acuity of 20/40 or better, while seven (36%) were 20/200 or worse. Ten eyes were injured in paintball games, (two formal and eight informal), while nine (47%) were injured by accidents or assaults not associated with any "game." Paintball injuries often cause severe and permanent visual loss. Nearly half of these injuries occur outside a war game setting as accidents or assaults.
Full Text Available A 21-year-old male patient presented to our hospital with a blunt paintball trauma to his left eye. The patient had corneal edema, traumatic cataract, traumatic mydriasis, and secondary glaucoma in his left eye. After corneal edema resolved, cataract surgery was performed. Because of uncontrolled intraocular pressure despite antiglaucoma medications, an Ahmed glaucoma valve was implanted. In the postoperative period, the patient’s visual acuity was 1/10. Paintball-related ocular injuries can be severe and visually devastating. (Turk J Ophthalmol 2013; 43: 135-7
Palamar, Melis; Degirmenci, Cumali; Ertam, Ilgen; Yagci, Ayse
Rosacea is a chronic cutaneous disorder which is known to cause inflammation and increased proteolytic activity on the ocular surface that might lead to corneal biomechanical alterations. The aim of this study is to evaluate the corneal biomechanical properties of ocular rosacea patients and compare the measurements with healthy individuals as measured with Reichert ocular response analyser (ORA). Besides full eye examination [best corrected visual acuity (BCVA), intraocular pressure (IOP) measured with Goldmann applanation tonometry (IOP-G)], central corneal thickness (CCT), and ORA [corneal hysteresis (CH), corneal resistance factor (CRF), corneal compensated IOP (IOPcc), Goldmann correlated IOP (IOPg)] measurements of 30 eyes of 15 ocular rosacea patients (study group) and 30 eyes of 15 healthy individuals (control group) were performed. For comparisons paired t test was used. Mean age of study group was 45.26 ± 11.65 (range 25 and 63) and control group was 45.00 ± 8.91 (range 26 and 58) years (p = 0.865). No significant difference in BCVA, CCT, IOP-G, IOPcc was detected among groups. However, IOPg, CH, and CRF in the study group were significantly lower than in the control group (p = 0.013, p = 0.013, p = 0.009, respectively). IOPg, CH, and CRF parameters of ocular rosacea patients were significantly lower than normal individuals. These differences and their probable clinical reflections that might effect making decisions in conditions such as glaucoma should be investigated in larger number of patients.
Full Text Available Objective To evaluate the predictive value of ocular trauma score(OTS in mechanical ocular injuries occurring in military forces,and compare the difference of OTS application between ocular injury caused by military training and non-military training.Methods The data of 633 inpatients from armed forces suffering from injury of 665 eyes were retrospectively reviewed.Of the 665 injured eyes,326 were injured during military training and 339 during non-military training.The likelihood of final visual acuity(VA calculated with the OTS score was compared with that by the present OTS study,and the correlation between the score and final VA was then analyzed.Results Compared with the distribution of final VA in standard OTS score,the ratio in category 1 was statistically different in present study(P 0.05.There were significant differences in ratio of category 3 between eyes injured by military and non-military training(P < 0.05,and both ratios in category 1 were significantly different compared with those in standard OTS(P < 0.01,e.g.the ratio of NLP was lower(50% vs 73%,P < 0.01;43% vs 73%,P < 0.01;and the ratio in category 2 was significantly different between the eyes injured by non-military training and standard OTS(P < 0.05.However,the OTS showed positive correlation with final VA in present study(P < 0.0001.Conclusion OTS calculated at initial examination may primarily provide a piece of prognostic information of mechanical ocular injuries,and is of special benefit for deciding a prompt management or for evacuation decision for severe ocular injuries caused by military training.
Bajaj-Luthra, A; VanSwearingen, J; Thornton, R H; Johnson, P C
As patients with facial paralysis regain facial nerve function, they must endure and adapt to complications associated with recovery, such as synkinesis. Synkinesis is the presence of unintentional movement in one area of the face when intentionally performing movement in another area of the face. We used the Maximal Static Response Assay of facial motion to better define the differences between eye closure-associated perioral motion in normal individuals, motion of the affected side in patients with synkinesis, and motion of the unaffected side in patients with synkinesis, thereby characterizing the syndrome of ocular to oral synkinesis. The study population consisted of 78 patients with clinically defined ocular to oral synkinesis of the left or right hemiface and 27 individuals without facial impairment (control subjects). We used the Maximal Static Response Assay to quantify facial motion on the affected and unaffected sides during the motions of eye closure and smile in both groups. Patients with ocular to oral synkinesis had decreased supraorbital and infraorbital motion of the orbicularis oculi during eye closure on both the affected and unaffected sides relative to control subjects. They also had increased modiolar motion during eye closure on both sides relative to control subjects. On the affected side, the modiolus tended to move laterally; on the unaffected side, the modiolus tended to move medially (i.e., toward the side affected by the synkinesis). Modiolar motion present during eye closure in patients with ocular to oral synkinesis was not statistically different from modiolar motion present during smile on the affected side (eye closure, 0.39 cm +/- 0.25; smile, 0.47 cm +/- 0.30, p > 0.05). Using the Maximal Static Response Assay, we have quantitatively defined synkinesis of the affected hemiface and have shown that movement of the unaffected hemiface is influenced by the synkinetic movements of the affected hemiface. These data may provide the
Faro, Augusto C N; Pereira-Gurgel, Virginia M; Salvatori, Roberto; Campos, Viviane C; Melo, Gustavo B; Oliveira, Francielle T; Oliveira-Santos, Alecia A; Oliveira, Carla R P; Pereira, Francisco A; Hellström, Ann; Oliveira-Neto, Luís A; Valença, Eugenia H O; Aguiar-Oliveira, Manuel H
Ocular function is fundamental for environmental adaptation and survival capacity. Growth factors are necessary for a mature eyeball, needed for adequate vision. However, the consequences of the deficiency of circulating growth hormone (GH) and its effector insulin-like growth factor I (IGF-I) on the physical aspects of the human eye are still debated. A model of untreated isolated GH deficiency (IGHD), with low but measurable serum GH, may clarify this issue. The aim of this study was to assess the ocular aspects of adult IGHD individuals who have never received GH therapy. Cross sectional study. Setting: University Hospital, Federal University of Sergipe, Brazil. Twenty-five adult (13 males, mean age 50.1years, range 26 to 70years old) IGHD subjects homozygous for a null mutation (c.57+1G>A) in the GHRH receptor gene, and 28 (15 males, mean age 51.1years, range 26 to 67years old) controls were submitted to an endocrine and ophthalmological assessment. Forty-six IGHD and 50 control eyes were studied. Visual acuity, intraocular pressure, refraction (spherical equivalent), ocular axial length (AL), anterior chamber depth (ACD), lens thickness (LT), vitreous depth (VD), mean corneal curvature (CC) and central corneal thickness (CCT). IGHD subjects exhibited unmeasurable serum IGF-I levels, similar visual acuity, intraocular pressure and LT, higher values of spherical equivalent and CC, and lower measures of AL, ACD, VD and CCT in comparison to controls, but within their respective normal ranges. While mean stature in IGHD group was 78% of the control group, mean head circumference was 92% and axial AL was 96%. These observations suggest mild ocular effects in adult subjects with severe IGF-I deficiency due to non-treated IGHD. Copyright © 2017 Elsevier Ltd. All rights reserved.
Mira-Agudelo, A; Lundström, L; Artal, P
The temporal dynamics of ocular aberrations are important for the evaluation of, e.g. the accuracy of aberration estimates, the correlation to visual performance, and the requirements for real-time correction with adaptive optics. Traditionally, studies on the eye's dynamic behavior have been performed monocularly, which might have affected the results. In this study we measured aberrations and their temporal dynamics both monocularly and binocularly in the relaxed and accommodated state for six healthy subjects. Temporal frequencies up to 100 Hz were measured with a fast-acquisition Hartmann-Shack wavefront sensor having an open field-of-view configuration which allowed fixation to real targets. Wavefront aberrations were collected in temporal series of 5 s duration during binocular and monocular vision with fixation targets at 5 m and 25 cm distance. As expected, a larger temporal variability was found in the root-mean-square wavefront error when the eye accommodated, mainly for frequencies lower than 30 Hz. A statistically-significant difference in temporal behavior between monocular and binocular viewing conditions was found. However, on average it was too small to be of practical importance, although some subjects showed a notably higher variability for the monocular case during near vision. We did find differences in pupil size with mono- and binocular vision but the pupil size temporal dynamics did not behave in the same way as the aberrations' dynamics.
Visual Impairment and Ocular Findings among Deaf and Hearing Impaired School Children in Central Region, Ghana. ... The overall prevalence of visual impairment was 5.8% among hearing impaired school children in the Central Region of Ghana. ... Keywords: Disability, eye, ear, refractive error, ocular deviation .
Injuries to the face and ocular structures could occur at the war front not only to the enemies, but also to unsuspecting friends of the security agents. We report here a case of ocular injury involving an air force personnel (lance corporal) who was mistakenly hit on the face by the back blast of a rocket‑propelled grenade shot ...
Corticosteroids are an effective treatment for ocular inflammation, but they must be used with caution. Corticosteroids are the most effective way to treat ocular inflammation. They relieve symptoms rapidly and often prevent permanent damage. These medications, however, must be used with caution, as use of ...
Orbito-ocular injuries with retained intra-orbital foreign bodies affecting both orbits are uncommon in civilian practice. This case report aims to highlight an unusual presentation of bilateral orbito-ocular injury with retained intra-orbital foreign bodies following accidental explosion of a locally fabricated dane gun.
Objective: To determine the optimal time and mode of administration of postoperative analgesics following ocular surgery. Background: Most elective ocular surgery are said to be accompanied by onlymild pain. This knowledge, however, is not available to the prospective patientand this usually results in undue fear of eye ...
Airbags are designed to protect occupants of motor vehicles from injuries in the event of a crash but have been implicated in some serious ocular injuries after road traffic accidents (RTAs). Diagnosis of airbag related ocular injuries requires a high index of suspicion. Using a retrospective hospital‑based, noninterventional ...
Ocular neoplasm is one of the least investigated ocular disorders in Nigeria. Although relatively rare, they play a role in causing blindness and even death in adults and children. In this study, the records of all patients/seen at the eye clinic and specimen received at the histopathology department of the University of Benin, ...
Materials and Methods: Participants were retired public servants who consented to ocular examinations at their pension pay points in Port Harcourt during the 2012 World Sight Day. Visual acuity, ocular examinations including fundoscopy and intraocular pressure measurements were recorded and subsequently analyzed ...
to ocular examinations at their pension pay points in Port Harcourt during the 2012 World Sight Day. Visual acuity, ocular examinations including fundoscopy and intraocular pressure measurements were recorded and subsequently analyzed using. Statistical Package for Social Sciences version 20. Results: Five hundred ...
This is because a delay in treatment for some causes of childhood blindness can lead to amblyopia. Furthermore, the number of “blind years” resulting from ... Refractive error (19.5%) was the most common ocular morbidity seen, followed by ocular trauma (13.1%), allergic conjunctivitis (11.1%) and cataract (10.9%).
biometry for calculation of optical power of artificial lens implants is another advantage of ocular .... Loss of vision. 8. 8. Photopsia. 3. 3. Bangal, et al.: Pattern of ocular pathologies diagnosed with B-scan ultrasonography. Nigerian Journal of Ophthalmology ¦ Jul-Dec 2016 ¦ Volume 24 ¦ Issue 2. 73. [Downloaded free from ...
Kijlstra, A.; Pedersen, E.
Despite large advances in the field of ocular toxoplasmosis, large gaps still exist in our knowledge concerning the epidemiology and pathophysiology of this potentially blinding infectious disease. Although ocular toxoplasmosis is considered to have a high health burden, still little is known about
Meenken, C.; Assies, J.; van Nieuwenhuizen, O.; Holwerda-van der Maat, W. G.; van Schooneveld, M. J.; Delleman, W. J.; Kinds, G.; Rothova, A.
This study was set up to determine the long term ocular and systemic sequelae in patients with severe congenital toxoplasmosis. Cross sectional and retrospective study of 17 patients with severe congenital toxoplasmosis. In addition to chorioretinitis (100%), the most common abnormal ocular features
Desirée C Murray
Full Text Available Ocular trauma is a significant cause of unilateral blindness in the Caribbean in both adults and children. In Trinidad and Tobago, blunt ocular injury will typically account for around a third of all referrals from the Accident and Emergency department to the ophthalmology unit.
Ocular examination was done on site with a pen torch, portable hand-held slit lamp bio-microscope and direct ophthalmoscope. ... Conclusion: There is need to safeguard the ocular health of sawmill workers in Nigeria by provision of eye safety devices, health education of the workers on the benefits of its use and ...
Clinical Evaluation of Ocular Antiviral Effect of Garcinia Kolanut Water Extract in Epidemic Haemorrhagic Keratoconjunctivitis in Lagos. ... Critical awareness and preventive measures are usually applied. These infections are ... They all used only the sterile Garcinia kolanut water extract as drops for their ocular complaints.
Objective: Pregnancy results in a lot of hormonal changes in the body and the eyes are no exception. These ocular changes could be physiologic, pathologic or a modification of a pre-existing condition. The aim of this study was to determine physiologic ocular changes that are associated with pregnancy in healthy Nigerian ...
The prevalence of ocular hazards in ophthalmic dispensing industry in south east Nigeria was carried out using 70 subjects drawn from different towns in the region. Tables were used to analyze the data obtained from his study. Results showed that ocular hazards are involved in ophthalmic dispensing depending on the ...
Dr Chijioke Onyeknowu
Conclusion: The yearly surgical uptake at EBSUTH was low and cataract extraction was the most common ocular surgery performed. Key words: ocular surgeries, analysis, EBSUTH, Abakaliki. INTRODUCTION. The eye clinic of Ebonyi State University Teaching Hospital. (EBSUTH), Abakaliki was revitalized and equipped ...
Background. A positive Hutchinsonfs sign indicates an increased risk of ocular involvement in herpes zoster ophthalmicus (HZO). We examined the sensitivity of Hutchinsonfs sign as an indicator of ocular involvement in a consecutive series of patients presenting with HZO. Methods. We conducted a descriptive ...
Vernal disease was the commonest ocular morbidity seen constituting 349 cases (40.3%), ocular trauma 152 (17.6%), infective conjunctivitis 106 (12.3%) and refractive errors 89 (10.2%). The location of industries (rice mills, sawmills, cement factory) away from residential areas, availability of antiallergic drugs must be ...
Dr Chijioke Onyeknowu
SUMMARY. Objective: To ascertain the number, types and frequencies of ocular surgeries done at Ebonyi State University Teaching. Hospital (EBSUTH), Abakaliki, with a view to improving the overall surgical uptake. Methods: A retrospective review of ocular surgeries done at. EBSUTH between January 2003 and April ...
Conclusion: This study has brought to light the many aspect of orbito-ocular tumours in Nigerian children and also highlighted the many problems caused by inadequate facilities for diagnosis and management. Key words: Orbito-ocular tumours, children, retinoblastoma, tumour sites. [Jnl College of Medicine Vol.7(2) 2002: ...
Background: Ocular morbidity patterns are indicative of the ocular health status of communities. They are significant pointers to the prevalent and emerging eye diseases in any country. The absence of professional eye care services in most Nigerian villages has necessitated the use of eye camps offering free ...
Conclusion: Syphilis can be presented initially as ocular uveitis without obvious systemic manifestation. Ophthalmologists play an important role in the early diagnosis and treatment of syphilis. If treated early enough, the response is good, even if the patient is allergic to penicillin. Awareness of the multiple manifestations of ocular syphilis is the key to early detection of the disease.
Justus G Garweg
Full Text Available Although parasite-mediated host cell lysis is deemed to be an important cause of tissue destruction in ocular toxoplasmosis (OT, the severity of the disease is probably correlated with hypersensitivity and inflammation. Notwithstanding, the mechanisms that regulate the inflammatory process in recurrent OT are poorly understood. Recent evidence has identified interleukin (IL 17 as a marker for disease severity. The ocular and cerebral presence of this cytokine is generally associated with the induction of autoimmune responses in the brain and the eye. Indeed, there are indications that autoimmunity may contribute to clinical variability in the activity of OT. IL-23, which induces the proliferation of IL-17-producing cells and IL-27, which is a counterplayer to IL-17, may regulate T(H-1-cell-mediated responses in OT. The importance of these cytokines in experimental models of uveitis and encephalitis has been recently reported. CD25(+ regulatory T-cells may control the local inflammatory response and protect the host against collateral inflammatory tissue damage. The responses of these cells to OT may be suitably tailored to cope with either an acquired or a congenital aetiology. Knowledge relating to immunoreactivity in OT has grown impressively during the past few years. Its characteristic and variable features have been identified and the potential relevance of autoimmunity has been assessed. In light of this knowledge, potential future treatment options have been considered.
Nam, Jayoung; Thibos, Larry N; Iskander, D Robert
A common optometric problem is to specify the eye's ocular aberrations in terms of Zernike coefficients and to reduce that specification to a prescription for the optimum sphero-cylindrical correcting lens. The typical approach is first to reconstruct wavefront phase errors from measurements of wavefront slopes obtained by a wavefront aberrometer. This paper applies a new method to this clinical problem that does not require wavefront reconstruction. Instead, we base our analysis of axial wavefront vergence as inferred directly from wavefront slopes. The result is a wavefront vergence map that is similar to the axial power maps in corneal topography and hence has a potential to be favoured by clinicians. We use our new set of orthogonal Zernike slope polynomials to systematically analyse details of the vergence map analogous to Zernike analysis of wavefront maps. The result is a vector of slope coefficients that describe fundamental aberration components. Three different methods for reducing slope coefficients to a spherocylindrical prescription in power vector forms are compared and contrasted. When the original wavefront contains only second order aberrations, the vergence map is a function of meridian only and the power vectors from all three methods are identical. The differences in the methods begin to appear as we include higher order aberrations, in which case the wavefront vergence map is more complicated. Finally, we discuss the advantages and limitations of vergence map representation of ocular aberrations.
Sabermoghaddam, Ali A; Zarei-Ghanavati, Siamak; Abrishami, Mojtaba
The goal of this study was to compare higher-order aberrations before and after upper lid chalazion excision. Fourteen eyes from 12 patients (8 females, mean age: 28.7 ± 2.7 years) with upper lid chalazion were enrolled in this prospective interventional case series. Chalazia were excised by standard transconjunctival vertical incision. Ocular aberrations were evaluated by aberrometry (ZyWave) before and 2 months after chalazion excision. Root mean square of total higher-order aberrations decreased from 0.67 ± 0.12 to 0.43 ± 0.15 μm (P = 0.012) after excision. The root mean square of Zernike orders in the vertical and horizontal trefoil and horizontal coma were decreased after excision. Orbscan IIz tomography showed a statistically significant decrease in 5 mm zone irregularity (P = 0.027) and an increase in minimum simulated keratometry after surgery (P = 0.046). Chalazion increases higher-order aberrations, as measured by the Hartmann-Shack aberrometer, which could affect the preoperative evaluation and results of refractive surgery, especially wavefront-guided approaches. Chalazion excision could reduce ocular aberrations and is recommended before refractive surgeries.
Łabuz, Grzegorz; López-Gil, Norberto; van den Berg, Thomas J T P; Vargas-Martín, Fernando
Multifocal contact lenses have been growing in popularity as a modality to correct presbyopic eyes, although visual side effects such as disability glare have been reported. The objective of this study was to investigate the effect of multifocal contact lenses on disability glare by means of ocular straylight. A prospective randomized, comparative study was performed that included 16 subjects free of ocular pathology. Straylight was measured using a commercial straylight meter with the natural and dilated pupil. Participants were fitted with Proclear Multifocal (Distance/Near), ACUVUE Oasys for Presbyopia, and Air Optix Aqua Multifocal randomized to the left or right eye. Straylight measurements were repeated with the contact lens in situ after the pupil dilation. Results obtained with the dilated pupil without contact lens acted as a control. Diameter of the natural and dilated pupil was 2.87 ± 0.40 mm and 7.45 ± 0.86 mm, respectively (P lenses, a significant difference was only found between Air Optix and the control group (P = .006). The latter showed also slightly increased light scatter. A difference in measured straylight was found between the studied multifocal lenses. The observed variability and the straylight-pupil size dependency should be taken into account to avoid elevated straylight in multifocal contact lens wearers. The reason for the observed differences in straylight must be the subject of future studies.
Holland, G.N.; O' Connor, G.R.; Diaz, R.F.; Minasi, P.; Wara, W.M.
To investigate the role of cellular immunodeficiency in recurrent toxoplasmic retinochoroiditis, six Cynomolgus monkeys (Macaca fascicularis) with healed toxoplasmic lesions of the retina were immunosuppressed by total lymphoid irradiation. Three months prior to irradiation 30,000 Toxoplasma gondii organisms of the Beverley strain had been inoculated onto the macula of eye in each monkey via a pars plana approach. Toxoplasmic retinochoroiditis developed in each animal, and lesions were allowed to heal without treatment. During total lymphoid irradiation animals received 2000 centigrays (cGy) over a 7-week period. Irradiation resulted in an immediate drop in total lymphocyte counts and decreased ability to stimulate lymphocytes by phytohemagglutinin. Weekly ophthalmoscopic examinations following irradiation failed to show evidence of recurrent ocular disease despite persistent immunodeficiency. Four months after irradiation live organisms were reinoculated onto the nasal retina of the same eye in each animal. Retinochoroidal lesions identical to those seen in primary disease developed in five of six animals. Toxoplasma organisms therefore were able to proliferate in ocular tissue following the administration of immunosuppressive therapy. This study fails to support the hypothesis that cellular immunodeficiency alone will initiate recurrent toxoplasmic retinochoroiditis. Results suggest that reactivation of disease from encysted organisms involves factors other than suppression of Toxoplasma proliferation. If reactivation occurs by other mechanisms, however, cellular immunodeficiency then may allow development of extensive disease.
Barisani-Asenbauer, T; Maca, S M; Hauff, W; Kaminski, S L; Domanovits, H; Theyer, I; Auer, H
The purpose of this study was to evaluate the efficacy of combined albendazole and steroid treatment for uveitis caused by Toxocara canis in immunocompetent patients. Five patients (7 eyes) with ocular larva migrans syndrome (OLM) were used in this study. Toxocariasis was suspected based on clinical manifestations and confirmed by anti-toxocara IgG and Western blot analysis. Systemic albendazole (adults: 800 mg b.i.d.; children: 400 mg b.i.d.) was given in conjunction with steroids. Visual acuity before and after therapy, inflammatory response, side effects and toxicity were evaluated. Treatment resulted in an improved visual acuity in all patients. Mean initial Snellen visual acuity was 20/40, and mean final acuity was 20/20. There were no recurrences of uveitis throughout the observation period (average: 13.8 months; range: 3 days to 24 months). These findings suggest that albendazole, in combination with systemic steroids, is a useful regimen to treat ocular larva migrans syndrome.
Kaiser, James M.; Imai, Hisanori; Haakenson, Jeremy K.; Brucklacher, Robert M.; Fox, Todd E.; Shanmugavelandy, Sriram S.; Unrath, Kellee A.; Pedersen, Michelle M.; Dai, Pingqi; Freeman, Willard M.; Bronson, Sarah K.; Gardner, Thomas W.; Kester, Mark
Nanoliposomal technology is a promising drug delivery system that could be employed to improve the pharmacokinetic properties of clearance and distribution in ocular drug delivery to the retina. We developed a nanoscale version of an anionic, cholesterol-fusing liposome that can encapsulate therapeutic levels of minocycline capable of drug delivery. We demonstrate that size extrusion followed by size-exclusion chromatography can form a stable 80-nm liposome that encapsulates minocycline at a concentration of 450 ± 30 μM, which is 2% to 3% of loading material. More importantly, these nontoxic nanoliposomes can then deliver 40% of encapsulated minocycline to the retina after a subconjunctival injection in the STZ model of diabetes. Efficacy of therapeutic drug delivery was assessed via transcriptomic and proteomic biomarker panels. For both the free minocycline and encapsulated minocycline treatments, proinflammatory markers of diabetes were downregulated at both the messenger RNA and protein levels, validating the utility of biomarker panels for the assessment of ocular drug delivery vehicles. PMID:22465498
Frane, S L; Sholtz, R I; Lin, W K; Mutti, D O
Acquired nonaccommodative esotropia describes the sudden onset of a constant, comitant strabismus of idiopathic origin in children >6 months of age. We present a case of acquired nonaccommodative esotropia at 20 months of age in a subject participating in the Berkeley Infant Biometry Study, a longitudinal study of emmetropization and ocular component development in infants between 3 months and 3 years of age. Ocular components for this child were normal before the onset of strabismus (within 2 SD's of the mean for orthotropic study participants) for refractive error, corneal power, lens radii, lens power, and ocular axial dimensions. Refractive error postsurgically was significantly more hyperopic and crystalline lens power lower than average at +2.38 D and 37.2 D, respectively. The lack of abnormal ocular parameters is consistent with the idiopathic etiology of acute onset esotropia. This case suggests that ocular component values may not be useful for assessing the risk of acquired nonaccommodative esotropia.
Mason, John O; Feist, Richard M; White, Milton F
We studied ocular injuries and visual outcome after blunt trauma from paintball pellets. We retrospectively reviewed cases of ocular injury from paintball pellets occurring over 32 months. Ten cases of ocular injury from paintball pellets were recorded. Most patients (9) were injured at home or at a friend's home; only 1 was injured at a war game facility. Six patients had surgery. Final visual acuity was 20/25 or better in 6 patients, 20/30 to 20/50 in 2 patients, 20/60 to 20/100 in 2 patients, and 20/200 in 1 patient. Traumatic maculopathy and epiretinal membrane formation were determinants of worse final visual acuity. Paintball pellet ocular injuries occur more frequently at home than at war game facilities. Advanced surgical techniques offer decreased ocular morbidity and improved visual acuity. Decreasing visual morbidity from paintball pellets requires public education, proper product labeling, and packaging of eye protection with all paintball-related products.
Barnes, Shawn S; Wong, William; Affeldt, John C
While airbags have saved many lives and are clearly beneficial overall, sodium hydroxide (NaOH) powder produced by the inflation reaction can cause significant alkali ocular injury if not irrigated promptly. Here we report a case of severe airbag related ocular alkali injury as a way to bring attention to the need for prompt ocular irrigation following motor vehicle accidents (MVA) with airbag deployment. A 47-year-old man was involved in a MVA with airbag deployment in a rural setting. Attention was paid to several other life-threatening traumatic injuries, however, ocular irrigation was not performed until some 6-7 hours after the MVA. Over the course of 6 months, airbag related alkali injury caused severe limbal ischemia, conjunctivalization of the cornea, corneal epithelial defects, cicatricial scarring, haze, and corneal/limbal vascularization despite amniotic membrane graft. Awareness of the importance of ocular irrigation following airbag deployment must be raised both in the ophthalmology and emergency medicine communities.
Cabalag, Miguel S; Wasiak, Jason; Syed, Quaderi; Paul, Eldho; Hall, Anthony J; Cleland, Heather
Ocular involvement in facial burns may lead to significant long-term morbidity. The aims of this study were to analyse the epidemiology, management and outcomes of ocular burn injuries, as well as to identify risk factors for developing early and late ocular complications. A retrospective medical chart review was conducted for 125 patients with ocular burns who were admitted to the Victorian Adult Burns Service (VABS), from November 2000 to January 2010. Univariate analyses was utilised to identify demographic and injury related variables associated with early and late complications. The majority of patients were male (n=101, 80.8%), and the mean (range) age was 40.7 (15-86) years. The most common mechanism was flame burns (n=77, 61.6%), and most were accidental (n=114, 91.2%). Early ocular complications occurred in 50 (40.0% [95% CI: 31.3%-49.1%]) patients, with the commonest being visual loss (n=39, 31.2%). Chemical burns, ocular discomfort, peri-orbital oedema, corneal injury, as well as eyelid and facial burns of increasing severity were associated with developing an early complication. Late ocular complications occurred in 19 (15.2% [95% CI: 9.4%-22.7%]) patients, with visual loss being the most frequent (n=13, 10.4%). Chemical burns, ocular discomfort, corneal injury of increasing severity, visual loss on presentation, ectropion, as well as eyelid burns of increasing depth were associated with late morbidity. Chemical burns, ocular discomfort, as well as corneal injury and eyelid burns of increasing severity were risk factors for both early and late ocular complications. III (retrospective comparative study). Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.
Full Text Available Background: Although ocular trauma is preventable public health problem throughout the world it is still one of the common causes of ophthalmic morbidity and monocular blindness. There are no published studies on pattern and severity of ocular trauma in Uttarakhand. The present study analyzes the pattern and visual outcome of ocular trauma in this region. Methods: Study design: Prospective hospital-based study. Settings: Patients of ocular trauma presenting to Ophthalmology OPD and emergency department of Himalayan Institute of Medical Sciences, Dehradun. Participants: All ocular injury patients seen for the first time during the period January to December 2008. Results: A total of 88 patients, and 103 eyes, were studied. Men had two fold higher rate of ocular injury than women. The mean age of presentation was 31.2 + 13.6 years (range: 6 - 80 years. The predominant age group of patients was 21-40 years, 55.29 % (n = 47. Eye injuries related to road traffic accident were seen in 37.86% of eyes. Industrial workers were more frequently involved in ocular trauma (23.86%. Closed globe injuries were noted in 55 eyes (53.39% and open globe injuries were noted in 40 eyes (38.83%. Eight eyes (7.76% suffered from chemical injuries. The initial presenting visual acuity of patients with blunt ocular trauma was better than penetrating injury. Eye with better visual acuity at presentation had better visual prognosis at 6 months. Conclusion: Ocular injuries were common in young males. Road traffic accidents related eye injuries were noted in significant number of cases. Strict implementation of traffic rules, health education and preventive strategies may help to decrease the occurrence of ocular injuries.
Full Text Available Background: Photomicrographs in Anatomic Pathology provide a means of quickly sharing information from a glass slide for consultation, education, documentation and publication. While static image acquisition historically involved the use of a permanently mounted camera unit on a microscope, such cameras may be expensive, need to be connected to a computer, and often require proprietary software to acquire and process images. Another novel approach for capturing digital microscopic images is to use smartphones coupled with the eyepiece of a microscope. Recently, several smartphone adapters have emerged that allow users to attach mobile phones to the microscope. The aim of this study was to test the utility of these various smartphone adapters. Materials and Methods: We surveyed the market for adapters to attach smartphones to the ocular lens of a conventional light microscope. Three adapters (Magnifi, Skylight and Snapzoom were tested. We assessed the designs of these adapters and their effectiveness at acquiring static microscopic digital images. Results: All adapters facilitated the acquisition of digital microscopic images with a smartphone. The optimal adapter was dependent on the type of phone used. The Magnifi adapters for iPhone were incompatible when using a protective case. The Snapzoom adapter was easiest to use with iPhones and other smartphones even with protective cases. Conclusions: Smartphone adapters are inexpensive and easy to use for acquiring digital microscopic images. However, they require some adjustment by the user in order to optimize focus and obtain good quality images. Smartphone microscope adapters provide an economically feasible method of acquiring and sharing digital pathology photomicrographs.
Full Text Available The vestibular organs consist of complementary sensors: the semicircular canals detect rotations while the otoliths detect linear accelerations, including the constant pull of gravity. Several fundamental questions remain on how the vestibular system would develop and/or adapt to prolonged changes in gravity such as during long-term space journey. How do vestibular reflexes develop if the appropriate assembly of otoliths and semi-circular canals is perturbed? The aim of present work was to evaluate the role of gravity sensing during ontogeny of the vestibular system. In otoconia-deficient mice (ied, gravity cannot be sensed and therefore maculo-ocular reflexes (MOR were absent. While canals-related reflexes were present, the ied deficit also led to the abnormal spatial tuning of the horizontal angular canal-related VOR. To identify putative otolith-related critical periods, normal C57Bl/6J mice were subjected to 2G hypergravity by chronic centrifugation during different periods of development or adulthood (Adult-HG and compared to non-centrifuged (control C57Bl/6J mice. Mice exposed to hypergravity during development had completely normal vestibulo-ocular reflexes 6 months after end of centrifugation. Adult-HG mice all displayed major abnormalities in maculo-ocular reflexe one month after return to normal gravity. During the next 5 months, adaptation to normal gravity occurred in half of the individuals. In summary, genetic suppression of gravity sensing indicated that otolith-related signals might be necessary to ensure proper functioning of canal-related vestibular reflexes. On the other hand, exposure to hypergravity during development was not sufficient to modify durably motor behaviour. Hence, 2G centrifugation during development revealed no otolith-specific critical period.
Beraneck, Mathieu; Bojados, Mickael; Le Séac'h, Anne; Jamon, Marc; Vidal, Pierre-Paul
The vestibular organs consist of complementary sensors: the semicircular canals detect rotations while the otoliths detect linear accelerations, including the constant pull of gravity. Several fundamental questions remain on how the vestibular system would develop and/or adapt to prolonged changes in gravity such as during long-term space journey. How do vestibular reflexes develop if the appropriate assembly of otoliths and semi-circular canals is perturbed? The aim of present work was to evaluate the role of gravity sensing during ontogeny of the vestibular system. In otoconia-deficient mice (ied), gravity cannot be sensed and therefore maculo-ocular reflexes (MOR) were absent. While canals-related reflexes were present, the ied deficit also led to the abnormal spatial tuning of the horizontal angular canal-related VOR. To identify putative otolith-related critical periods, normal C57Bl/6J mice were subjected to 2G hypergravity by chronic centrifugation during different periods of development or adulthood (Adult-HG) and compared to non-centrifuged (control) C57Bl/6J mice. Mice exposed to hypergravity during development had completely normal vestibulo-ocular reflexes 6 months after end of centrifugation. Adult-HG mice all displayed major abnormalities in maculo-ocular reflexe one month after return to normal gravity. During the next 5 months, adaptation to normal gravity occurred in half of the individuals. In summary, genetic suppression of gravity sensing indicated that otolith-related signals might be necessary to ensure proper functioning of canal-related vestibular reflexes. On the other hand, exposure to hypergravity during development was not sufficient to modify durably motor behaviour. Hence, 2G centrifugation during development revealed no otolith-specific critical period.
Bachmann, B; Cursiefen, C
Severe chemical burns of the ocular surface frequently result in long-standing and ongoing disorders of the conjunctiva and the cornea including conjunctival scarring with shortening of the fornix, cicatricial entropion, complications caused by trichiasis and scarring or chronic ulceration of the cornea. Advanced destruction of limbal stem cells leads to limbal stem cell deficiency with conjunctivalization of the cornea. Surgical therapy aims at the correction of malpositioning of the lids, the reconstruction of the conjunctiva and the fornix utilizing applicable tissue grafts and the reestablishment of a stable, avascular and transparent corneal epithelium by e.g. transplantation of epithelial stem cells. Progressive corneal ulcerations unresponsive to medical therapy can be treated by amniotic membrane transplantation, corneal transplantation or by conjunctival covering depending on the extent of damaged tissue. The surgical therapy of patients after severe chemical burns of the ocular surface is generally performed in specialized centers and occasionally requires a multidisciplinary approach.
Sílvia Ligório Fialho
Full Text Available O método mais comum de administração de drogas no olho é por meio de colírios. Entretanto, por este método, não é possível atingir a concentração terapêutica nos fluidos e tecidos posteriores do olho. A administração sistêmica apresenta reduzido acesso ao segmento posterior do olho devido à presença das barreiras oculares. Injeções subconjuntivais e retrobulbares não são capazes de proporcionar níveis adequados da droga, e a injeção intravítrea é método invasivo, inconveniente e que apre-senta riscos de perfuração do bulbo ocular ou descolamento da retina. A iontoforese, no entanto, apresenta-se como alternativa para o transporte de doses terapêuticas de drogas para o segmento posterior do olho. A iontoforese é uma técnica que consiste na administração de drogas para o organismo através dos tecidos, utilizando um campo elétrico. O eletrodo ativo, que se encontra em contato com a droga, é colocado no local a ser tratado, e um segundo eletrodo, com a finalidade de fechar o circuito elétrico, é colocado em outro local do organismo. O campo elétrico facilita o transporte da droga, que deve se encontrar, preferencialmente, na forma ionizada. A iontoforese pode ser considerada como um método seguro e não invasivo de transporte de drogas para locais específicos do olho. Aplicada experimentalmente para o tratamento de doenças oculares, esta técnica tem evoluído muito nos últimos anos e, atualmente, testes clínicos de fase III encontram-se em andamento.The most traditional method of ocular drug delivery is through the use of eyedrops. However, by this method, the therapeutic concentration in deep ocular fluids and tissues can not be efficiently reached. Systemic administration presents poor access to the posterior segment of the eye due to ocular barriers. Subconjuntival and retrobulbar injections are not able to produce adequate levels of the drug, and intravitreal injection is an invasive and problematic
Alejandro Arias Díaz
Full Text Available Se realizó una descripción de los aspectos clínicos y el manejo terapéutico del trauma ocular en edades pediátricas. Se identifican las particularidades a abordar en estos pacientes con presencia de cataratas traumáticas y/o heridas penetrantes corneales, por las diferencias en el manejo de las mismas en estas edades y en la adultez. Se hace énfasis en el hifema traumático.The clinical aspects and the treatment management of the ocular trauma at pediatric ages were described. Those particularities to be taken into account when approaching these patients who suffer traumatic cataracts and/or penetrating corneal injuries were indentified, on the account of the differences in the management of this disease between children and adults. Emphasis was made on the description of traumatic hyphema.
Full Text Available TNF-related apoptosis inducing ligand (TRAIL is an intensively studied cytokine, in particular for its anticancer activity. The discovery that conjunctival sac fluid contains extremely high levels of soluble TRAIL as compared to other body fluids suggested important implications in the context of the immunological surveillance of the eye, in particular of the anterior surface. In this review, we discuss the potential physiopathologic and therapeutic role of the TRAIL/TRAIL receptor system in a variety of ocular cancers. Moreover, since an increasing amount of data has indicated the important biological activities of the TRAIL/TRAIL receptor systems also in a completely different pathologic context such as diabetes mellitus, in the second part of this review we summarize the currently available data on the involvement of TRAIL in the ocular complications of diabetes mellitus as modulator of the inflammatory and angiogenic response in the eye.
Perri, Paolo; Zauli, Giorgio; Gonelli, Arianna; Milani, Daniela; Celeghini, Claudio; Lamberti, Giuseppe; Secchiero, Paola
TNF-related apoptosis inducing ligand (TRAIL) is an intensively studied cytokine, in particular for its anticancer activity. The discovery that conjunctival sac fluid contains extremely high levels of soluble TRAIL as compared to other body fluids suggested important implications in the context of the immunological surveillance of the eye, in particular of the anterior surface. In this review, we discuss the potential physiopathologic and therapeutic role of the TRAIL/TRAIL receptor system in a variety of ocular cancers. Moreover, since an increasing amount of data has indicated the important biological activities of the TRAIL/TRAIL receptor systems also in a completely different pathologic context such as diabetes mellitus, in the second part of this review we summarize the currently available data on the involvement of TRAIL in the ocular complications of diabetes mellitus as modulator of the inflammatory and angiogenic response in the eye.
Marta Lucía Muñoz Cardona
Full Text Available The most frequent primary headaches, including migraine variants, and intrinsic optic nerve disorders that produce headache, are reviewed. The latter are often accompanied by autonomic nervous system alterations which lead to vasomotor changes, frequently present in neuralgic processes known as headaches with disautonomic involvement. Epidemiological, semiological, clinical, and therapeutical aspects of different cranial, facial and ocular diseases that produce headache are included. Some physiopathological elements that may help to analyze painful craniofacial processes are discussed. Secondary headaches and common facial neuralgias, on the other hand, are also considered because they may confuse the differential diagnosis. Se revisan las cefaleas primarias más frecuentes que comprometen las estructuras oculares y vecinas al globo ocular, las variantes de la migraña y las alteraciones propias del nervio óptico que alteran la función visual y que se acompañan no solamente de síntomas dolorosos sino también de trastornos vasomotores debidos a alteraciones del sistema nervioso autónomo que suelen ser comunes en algunos procesos neurálgicos llamados ahora cefaleas con compromiso disautonómico. En este artículo se comentan los elementos epidemiológicos de las diferentes enfermedades craneales, faciales y oculares que cursan con cefalea; las diferencias clínicas entre las mismas y su presentación semiológica, al igual que algunos elementos terapéuticos. Se discuten además algunos elementos fisiopatológicos de gran utilidad en el análisis de los procesos dolorosos craneofaciales y el perfil temporal de los mismos; también se comentan algunas cefaleas secundarias que comparten con las primarias elementos que se prestan a confusión en la clínica. Finalmente, se hace un análisis de las neuralgias faciales comunes.
Lavaju, P; Arya, S K; Sinha, A; Pandey, S; Adhikari, S; Shrestha, B G; Chetan, S; Agarwal, T L
ocular tumors are commonly encountered in ophthalmic practice. to study the clinical pattern of ocular tumors in the eastern region of Nepal. the hospital records of patients with ocular tumors treated at B P Koirala Institute of Health Sciences in the eastern region of Nepal over a period of 5 years (April 2003 - March 2008) were studied retrospectively. of 115 consecutive patients with ocular tumors, 40 (34.75%) were below the age of 21 years, 41 (35.65%) were in the age group of 21-50 years and 34 (29.56%) of age above 50 years. There were 48 (41.73%) and 67 (58.26%) patients with benign and malignant tumors respectively. The common benign tumors were conjunctival papilloma, dermoid cysts, nevus, cystic lesions and hemangioma. Among the malignant tumors, basal cell carcinoma was the commonest (22.38%). Retinoblastoma was the most common ocular malignant tumor in the pediatric age group (88.8%). Basal cell carcinoma was the commonest eyelid malignancy (53.57%). conjunctival papilloma, dermoid cysts, nevus, cystic lesions and hemangioma are common benign ocular tumors, whereas basal cell carcinoma and retinoblastoma are the commonest ocular malignancies in adults and children respectively.
Full Text Available Ocular trauma is a very common incidence that occurs in up to 67% of patients with maxillofacial trauma. It results in life-long agony of not being like others with two eyes, which can see and admire the nature's beauty. This article reports on a case of a 23-year-old male patient with phthisis bulbi, resulting from ocular trauma. The patient was rehabilitated aesthetically by fabrication of custom-made ocular prosthesis for his traumatically injured right eye. The patient was pleased with the aesthetic outcome, comfort, and mobility offered by the custom ocular prosthesis. There were no complications with regard to health of underlying residual ocular tissues and there was no need of relining of the prosthesis at 6 month recall appointment. Rehabilitation of patients with ocular trauma requires a multidisciplinary approach involving ophthalmologist, psychologist, and skilled maxillofacial prosthodontist. Custom-made ocular prosthesis fitted over the phthisical globe seems to be a highly positive, logical, noninvasive, and beneficial approach to increase mobility to the prosthesis, improve the cosmetic appearance and psychological well-being of the patient.
Full Text Available AIM:To investigate the influence of ocular perfusion pressure fluctuation on glaucoma. METHODS:Forty patients with primary open angle glaucoma from January 2013 to June 2015 in our hospital were used as observation group and 40 families were used as control group. Circadian fluctuation of intraocular pressure, blood pressure and ocular perfusion pressure in 24h were determined to obtain systolic ocular perfusion pressure(SOPP, diastolic ocular perfusion pressure(DOPPand mean ocular perfusion pressure(MOPP. Pearson linear correlation was used to analyze the correlation of circadian MOPP fluctuation with cup-disc ratio, mean defect(MDand the picture standard deviation(PSD. RESULTS:The fluctuation of MOPP, SOPP and DOPP of observation group were significantly higher than those of control group(Pr=-0.389, 95%CI:-0.612～-0.082; P=0.011, was positively correlated with PSD(r=0.512, 95%CI:0.139 ～0.782; P=0.008; no correlation was found between it and the vertical cup-disc ratio(r=0.115, 95%CI:0.056～0.369; P=0.355. CONCLUSION:Ocular perfusion pressure fluctuations in patients with primary open angle glaucoma may reflect the severity of the disease and may make the situation aggravating. Therefore through perfusion pressure monitor in 24h may help us understand the ocular blood flow and the development of primary open-angle glaucoma.
Ho, Raymond; Thompson, Benjamin; Babu, Raiju J; Dalton, Kristine
Ocular dominance can be defined as the preference of an individual for viewing with one eye over the other for particular visual tasks. It is relevant to monovision contact lens wear, cataract surgery and sports vision. Clinically, the measurement of ocular dominance is typically done at an arbitrary distance using a sighting test, such as the hole-in-card method that has a binary outcome. We investigated the effect of test distance on ocular dominance measured using a binocular sighting test that provided a continuous measurement of dominance. Ten participants with normal binocular vision took part in this study. Their binocular sighting ocular dominance and phorias were measured at one, two, four, eight and 10 metres. During the dominance tests participants made a binocular alignment judgment and then were asked to indicate the relative alignment of each eye using a visual analogue scale as a reference. Eight participants had strong ocular dominance (five right, three left). For these participants, there was a significant increase in the magnitude of dominance with increasing test distance (p 0.05), despite changes in convergence demand. When ocular dominance is present, its magnitude varies significantly with test distance. This has significant implications for the accurate measurement of ocular dominance in the clinic and may reflect the neural processes that influence eye preference. © 2017 Optometry Australia.
Mao, Chen; Hsu, Chien-Chin; Chen, Kuo-Tai
An ocular jellyfish sting is an ophthalmic emergency and is rarely reported in the medical literature. With the evolution of aquatic activities and entertainment in recent decades, we anticipate that more patients with ocular jellyfish stings may be taken to the emergency department. However, most physicians are unaware of the typical presentations, suitable treatments, prognosis, and possible complications of ocular jellyfish stings. We reported 2 cases with ocular jellyfish stings and collected cases series from literature review. The most common clinical features of ocular jellyfish stings were pain, conjunctival injection, corneal lesion, and photophobia. All patients who sustained ocular stings did so during aquatic activities, and the best management at the scene was proper analgesics and copious irrigation of affected eyes with seawater or saline. The ocular lesions were treated with topical cycloplegics, topical steroids, topical antibiotics, topical antihistamines, and removal of nematocysts. The prognosis was good, and all patients recovered without any permanent sequelae. However, symptoms in some patients may last longer than 1 week. Reported complications included iritis, increased intraocular pressures, mydriasis, decreased accommodation, and peripheral anterior synechiae. Copyright © 2016 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.
Gehlsen, U; Cursiefen, C; Steven, P
Ocular allergy belongs to the most common ocular diseases globally. Following clinical phenotype and immunopathogenesis different forms of allergy are distinguished, which require different forms of therapeutic approach. This manuscript reviews the basic immunological processes involved in the development of ocular allergies and current and future therapeutic approaches. Results of a literature search in PubMed and our own clinical and experimental experience are presented. In the immunopathogenesis of ocular allergy different immune cells such as dendritic cells, B-cells, T-cells, mast cells, eosinophils and regulatory T-cells are involved. Therapeutic approaches focus on either relief of symptoms using antihistamins or mast cell stabilisers or combinations of both. In severe cases steroids or calcineurin inhibitors are used. Despite great progress in the investigation of ocular allergy in the past decade several open questions remain, such as the relation of ocular allergy with dry eye disease. Future therapeutic approaches will likely be based on recently identified new aspects such as lymphangiogenesis and will allow better and potentially causal treatment of ocular allergy. Georg Thieme Verlag KG Stuttgart · New York.
Krause, Irit; Snir, Moshe; Cleper, Roxana; Fraser, Abigail; Kovalski, Yael; Axer Siegel, Ruth; Bar-Nathan, Nathan; Davidovits, Miriam
Ocular complications after renal transplantation are common in adults. Nevertheless, data regarding these complications in children are insufficient. The purpose of the present study was to assess ocular morbidity in pediatric renal graft recipients. A retrospective observational study of 71 patients aged 11.2 +/- 5.5 yr was conducted. Mean duration of follow-up was 5.6 +/- 3.5 yr. A total of 16 ocular complications were found in 12 (17%) of the patients. Three patients suffered from more than one complication. Cataract was the most common finding (six patients, 8.4%) followed by swollen disk and hypertensive retinopathy in four patients (5.7%) each and increased intra-ocular pressure in two patients (3%). Mean time interval between transplantation and occurrence of first abnormal ocular finding was 37 +/- 34.5 months. The follow-up time was significantly longer in patients with ophthalmological problems than in those without complications (7.8 yr vs. 5.2 yr, p < 0.02). No statistically significant association was found between the occurrence of ocular complications and the age of the patients at transplantation, donor source, duration of dialysis prior to transplantation, previous corticosteroid therapy or presence of acute rejection episodes. The results of the study point to the importance of regular concurrent ophthalmological follow-up in pediatric renal graft recipients to reduce/prevent ocular morbidity. (c) 2009 Wiley Periodicals, Inc.
Giese, Michael J; Speth, Robert C
The renin-angiotensin system (RAS) is most well-known for its role in regulation and dysregulation of blood pressure as well as fluid and electrolyte homeostasis. Due to its ability to cause cardiovascular disease, the RAS is the target of a multitude of drugs that antagonize its pathophysiological effects. While the "classical" RAS is a systemic hormonal system, there is an increasing awareness of the existence and functional significance of local RASs in a number of organs, e.g., liver, kidney, heart, lungs, reproductive organs, adipose tissue and adrenal. The eye is one of these organs where a compelling body of evidence has demonstrated the presence of a local RAS. Individual components of the RAS have been shown to be present in many structures of the eye and their potential functional significance in ocular disease states is described. Because the eye is one of the most important and complex organs in the body, this review also discusses the implications of dysregulation of the systemic RAS on the pathogenesis of ocular diseases and how pharmacological manipulation of the RAS might lead to novel or adjunctive therapies for ocular disease states. Copyright © 2013 Elsevier Inc. All rights reserved.
Masket, Samuel; Ceran, Basak Bostanci
We present an interventional case report of an 83-year-old woman who developed ocular hemosiderosis secondary to massive retinal and intravitreal bleeding associated with a choroidal neovascular membrane as a result of age-related macular degeneration. Anterior segment manifestations included low-grade inflammation, posterior synechiae, reversible hyperchromic heterochromia, and a mature cataract with "leopard spots." The longstanding vitreous hemorrhage was thought to be the etiology of these findings. At the request of the vitreoretinal surgeon, cataract surgery was performed to provide visualization of the posterior segment. However, the patient's visual potential was limited by her underlying retinal pathology. Neither author has a financial or proprietary interest in any material or method mentioned. Additional disclosure is found in the footnotes. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.
Full Text Available The leishmaniases are parasitic diseases that are transmitted to humans by infected female sandflies. Cutaneous leishmaniasis (CL is one of 3 main forms of the disease. CL is the most common form of the disease and is endemic in many urban and rural parts of Iran and usually caused by two species of Leishmania: L. major and L. tropica. We report a case of unusual leishmaniasis with 25 lesions on exposed parts of the body and right eyelid involvement (ocular leishmaniasis. The patient was a 75-year-old male farmer referred to health care center in Aran va Bidgol city. The disease was diagnosed by direct smear, culture, and PCR from the lesions. PCR was positive for Leishmania major.
L. K. Moshetova
Full Text Available Structural changes in eyes are present in all patients with chronic kidney disease. A study to detect ocular patho- logy in patients with end-stage chronic renal failure after kidney transplantation in the early and late postopera- tive period compared with patients receiving replacement therapy with hemodialysis. Revealed that in the early post-transplant period in recipients of kidneyas in patients on hemodialysis, continued angioretinopatiya, 40% of patients had «dry eye syndrome». In the delayed post-transplant period, patients showed significant impro- vement in the retina and retinal vessels, the improvement of spatial-temporal parameters of visual perception. However, a decrease of visual acuity on the background of the development of posterior subcapsular cataract caused by prolonged corticosteroid, and an increased incidence of viral and bacterial conjunctivitis.
Chandra Sekhar G
Full Text Available Purpose: To study the optic disc size in eyes with ocular hypertension (OHT in comparison to primary open-angle glaucoma (POAG and normals. Methods: Optic disc photographs obtained with the Nidek 3dx NM camera were digitized (Nikon coolscan and disc area calculated using Littmann correction in a randomly chosen eye of 28 OHT, 42 POAG and 30 normal subjects. OHT was defined as increased intraocular pressure with no disc or field changes suggestive of glaucoma with open angles. Results: The optic disc area in OHT was 9.47 ± 1.09 mm2; 12.27 ± 2.87mm2 in POAG; and 12.11 ± 2.83 mm2 in normal individuals. Conclusion: Using magnification corrected morphometry and the criteria for OHT diagnosis, the optic disc area in OHT was significantly smaller (p<0.0001 in POAG and normals.
Michalewska, Zofia; Michalewski, Janusz; Nawrocka, Zofia; Nawrocki, Jerzy
A presentation of two patients with macular hole after ocular trauma due to paintball. HRT, OCT, SOCT and visual field examinations were performed preoperatively and on 3 postoperative visits. Patients underwent pars plana vitrectomy with trypan blue staining. Final visual acuity 0.6 was achieved in the first patient 6 months after surgery. Best corrected visual acuity 0.2 was achieved in the second patient 3 months after surgery. Macular hole closure was observed on OCT, SOCT, HRT and indirect ophthalmoscopy examination. Pars plana vitrectomy with trypan blue staining and fluid-air exchange is a safe procedure in posttraumatic macular holes. HRT, Oct and SOCT are valuable tools for diagnosis of macular holes and for control after surgical intervention.
González, Jully; Atehortúa, Angélica; Moncayo, Ricardo; Romero, Eduardo
Cerebral palsy (CP) is a large group of motion and posture disorders caused during the fetal or infant brain development. Sensorial impairment is commonly found in children with CP, i.e., between 40-75 percent presents some form of vision problems or disabilities. An automatic characterization of the cerebral palsy is herein presented by estimating the ocular motion during a gaze pursuing task. Specifically, After automatically detecting the eye location, an optical flow algorithm tracks the eye motion following a pre-established visual assignment. Subsequently, the optical flow trajectories are characterized in the velocity-acceleration phase plane. Differences are quantified in a small set of patients between four to ten years.
Flávia Silva Villas-Bôas
Full Text Available OBJETIVO: O objetivo deste estudo foi determinar a prevalência e gravidade das complicações oculares em pacientes com mucopolissacaridoses (MPS. MÉTODOS: Vinte e nove pacientes com diagnóstico de mucopolissacaridoses foram estudados. Foram avaliados: idade, sexo, acuidade visual, presença de estrabismo, erros refrativos, exame de fundo de olho, pressão intraocular, espessura corneal central e ultrassonografia ocular. RESULTADOS: Foram avaliados três pacientes com MPS I (12%, 11 pacientes com MPS II (37,9%, um paciente com MPS III (3,4% e 14 pacientes com MPS VI (48,3%. A média de idade foi de 9,5 anos (DP 5,5. Observou-se hipermetropia em 88,5% (23 pacientes e astigmatismo em 51,7% (15 pacientes. A média da acuidade visual corrigida foi de 0,45 logMAR (DP 0,68. A média do equivalente esférico foi +3,57 D (DP 2,46 e da pressão intraocular foi 17 mmHg (DP 3,9. Os achados mais comuns foram: espessamento palpebral 24,1% (7 pacientes; opacidade da córnea, 55,2% dos casos (16 pacientes; atrofia do nervo óptico, 23,1% (6 pacientes; dobras radiais na retina 24% (7 pacientes. O fundo de olho não foi examinado em 3 pacientes devido à opacidade de córnea. A média da espessura do complexo esclera-retina-coroide (ERC medida por ultrassom foi de 1,78 mm (DP 0,51. CONCLUSÃO: Os achados oftalmológicos mais proeminentes foram espessamento palpebral, diminuição da acuidade visual, hipermetropia moderada, opacidade da córnea, dobras radiais na retina perimacular e atrofia do nervo óptico.
Cevik, Pinar; Dilber, Erhan; Eraslan, Oguz
Loss of an eye caused by cancer, trauma, or congenital defect creates a deep psychological impact on an individual's life especially social and professional life. Custom-made prosthesis, compared to stock prosthesis, provides a better fit to the eye socket, better cosmetic results, and less discomfort to the patient in the long term. The main objective of this article was to describe 3 different alternative and practical techniques of fabricating custom-made ocular prosthesis. An impression of anophthalmic socket was made with the addition of cured silicone-based precision impression material in all techniques. A master cast was prepared and duplicated with condensation silicone. A self-cure acrylic resin was polymerized in the silicone model and was fitted into the patient's eye socket. A digital photograph of the patient's iris was made using a digital camera and printed on good-quality photo paper in various shades and sizes in the first and the second techniques. Then the photo paper was coated with PVC so as not to allow any color flowing. The proper iris was then inserted to the acrylic base. The prosthesis was final processed using orthodontic heat polymerizing clear acrylic resin.In the other technique, after the trying-in process with wax pattern, an acrylic base was fabricated using heat polymerizing scleral acrylic resin. The prosthetic iris was fabricated from a transparent contact lens by painting the lens with watercolor paints and attaching it to an acrylic resin with tissue conditioner. The final process was made with heat polymerizing transparent acrylic resin. Custom-made prosthesis allows better esthetic and functional results to the patient in comparison to stock prosthesis. Further follow-up is necessary to check the condition and fit of the ocular prosthesis in such patients.
Full Text Available June Chen1, Stephen A Runyan1, Michael R Robinson21Department of Biological Sciences, 2Ophthalmology Clinical Research, Allergan, Inc, Irvine, CA, USAIntroduction: Glaucoma is a multifactorial disease characterized by progressive optic nerve injury and visual field defects. Elevated intraocular pressure (IOP is the most widely recognized risk factor for the onset and progression of open-angle glaucoma, and IOP-lowering medications comprise the primary treatment strategy. IOP elevation in glaucoma is associated with diminished or obstructed aqueous humor outflow. Pharmacotherapy reduces IOP by suppressing aqueous inflow and/or increasing aqueous outflow.Purpose: This review focuses on novel non-FDA approved ocular antihypertensive compounds being investigated for IOP reduction in ocular hypertensive and glaucoma patients in active clinical trials within approximately the past 2 years.Methods: The mode of IOP reduction, pharmacology, efficacy, and safety of these new agents were assessed. Relevant drug efficacy and safety trials were identified from searches of various scientific literature databases and clinical trial registries. Compounds with no specified drug class, insufficient background information, reformulations, and fixed-combinations of marketed drugs were not considered.Results: The investigational agents identified comprise those that act on the same targets of established drug classes approved by the FDA (ie, prostaglandin analogs and β-adrenergic blockers as well as agents belonging to novel drug classes with unique mechanisms of action. Novel targets and compounds evaluated in clinical trials include an actin polymerization inhibitor (ie, latrunculin, Rho-associated protein kinase inhibitors, adenosine receptor analogs, an angiotensin II type 1 receptor antagonist, cannabinoid receptor agonists, and a serotonin receptor antagonist.Conclusion: The clinical value of novel compounds for the treatment of glaucoma will depend
Anthony, Scott A; Thurtell, Matthew J; Leigh, R John
PURPOSE.: Miller Fisher syndrome (MFS) is a rare immune-mediated neuropathy that commonly presents with diplopia after the acute onset of complete bilateral external ophthalmoplegia. Ophthalmoplegia is often accompanied by other neurological deficits such as ataxia and areflexia that characterize MFS. Although MFS is a clinical diagnosis, serological confirmation is possible by identifying the anti-GQ1b antibody found in most of the affected patients. We report a patient with MFS who presented with clinical signs suggestive of ocular myasthenia gravis but in whom the correct diagnosis was made on the basis of serological testing for the anti-GQ1b antibody. CASE REPORT.: An 81-year-old white man presented with an acute onset of diplopia after a mild gastrointestinal illness. Clinical examination revealed complete bilateral external ophthalmoplegia and left-sided ptosis. He developed more marked bilateral ptosis, left greater than right, with prolonged attempted upgaze. He was also noted to have a Cogan lid twitch. Same day evaluation by a neuro-ophthalmologist revealed mild left-sided facial and bilateral orbicularis oculi weakness. He had no limb ataxia but exhibited a slightly wide-based gait with difficulty walking heel-to-toe. A provisional diagnosis of ocular myasthenia gravis was made, and anticholinesterase inhibitor therapy was initiated. However, his symptoms did not improve, and serological testing was positive for the anti-GQ1b immunoglobulin G antibody, supporting a diagnosis of MFS. CONCLUSIONS.: Although the predominant ophthalmic feature of MFS is complete bilateral external ophthalmoplegia, it should be recognized that MFS has variable associations with lid and pupillary dysfunction. Such confounding neuro-ophthalmic features require a thorough history, neurological examination, neuroimaging, and serological testing for the anti-GQ1b antibody to arrive at a diagnosis of MFS.
Kheirkhah, Ahmad; Casas, Victoria; Li, Wei; Raju, Vadrevu K; Tseng, Scheffer C G
To report the corneal manifestations in eyes with Demodex infestation of the eyelids. Noncomparative, interventional case series. This retrospective review included six patients with Demodex blepharitis who also exhibited corneal abnormalities, which led to suspicion of limbal stem cell deficiency in three cases. All patients received weekly lid scrubs with 50% tea tree oil and a daily lid scrubs with tea tree shampoo for a minimum of six weeks. Improvement of symptoms and corneal and conjunctival signs were evaluated. All six patients exhibited ocular irritation and conjunctival inflammation, while meibomian gland dysfunction (n = 5), rosacea (n = 4), and decreased vision (n = 3) also were noted despite prior treatments with oral tetracycline, topical steroids with antibiotics, and lid scrub with baby shampoo. These patients were proven to have Demodex folliculorum (n = 6) and Demodex brevis (n = 3) by microscopic examination of epilated lashes. Their corneal manifestation included superficial corneal vascularization (six eyes of five cases), marginal corneal infiltration (two eyes of two cases), phlyctenule-like lesion (one eye of one case), superficial corneal opacity (two eyes of two cases), and nodular corneal scar (two eyes of two cases). After treatment, the Demodex count was reduced from 6.8 +/- 2.8 to 1 +/- 0.9 (standard deviation; P = .001). All patients showed dramatic resolution of ocular irritation, conjunctival inflammation, and all inflammatory, but not scarred, corneal signs; three patients showed improved vision. A variety of corneal pathologic features together with conjunctival inflammation, commonly noted in rosacea, can be found in patients with Demodex infestation of the eyelids. When conventional treatments for rosacea fail, one may consider lid scrub with tea tree oil to eradicate mites as a new treatment.
Full Text Available "nBackground: Vitiligo is a common acquired disorder characterized by depigmented cutaneous patches devoid of melanocytes. The disease carries a risk for ocular abnormalities. Few reports are available about the ocular findings and their possible association with the disease in patients with vitiligo in the literature."n "nMethods: A total of 72 patients with previously documented cutaneous vitiligo were examined for ocular findings and 50 healthy individuals were enrolled as the control group in Razi Hospital in Tehran, Iran during years 2007-2008. Demographic features including age, gender, duration of the disease, presence of any accompanying autoimmune diseases, type of vitiligo and its anatomical distribution were recorded to investigate a possible association between the disease and the ocular findings."n "nResults: Amongst 72 patients with vitiligo, 11 (15.3% had ocular findings including retinal pigment epithelium hypopigmentation, posterior pole pigment changes, peripheral iris atrophy, atrophy of retinal pigment epithelium and iris hyperpigmentation. Amongst the controls, only two cases (4% had ocular findings which consisted of iris hyperpigmentation. The relationship between ocular findings and vitiligo was statistically significant (p= 0.04. No other remarkable features, such as age, gender, age at the onset of the disease, type of vitiligo, presence of priorbital lesions or body surface area involvement by the disease, were suggestive of an association or presenting a risk factor for vitiligo."n "nConclusion: Although the sample size and prevalence of ocular findings were not satisfactory enough to make a definite conclusion, we found a higher occurrence of ocular findings in patients with vitiligo than the control group.
Zarra, T; Lambrianidis, T
To investigate amongst Greek endodontists, the incidence of ocular accidents during practice, the circumstances associated with them, the therapeutic measures taken after the accidents, their compliance with the use of eye protection and their eye care behaviour. One hundred and forty-seven endodontists met the inclusion criteria and were invited to participate in the survey. Data were gathered through interviews based on a questionnaire. Participants were asked for personal/professional data, information on ocular accidents in the past 5 years, post-accident actions and the type of eye protection used. Their eyesight status and frequency of ocular examination were also recorded. Data were analysed using chi-square test, independent samples t-test and logistic regression. The level of significance was set at P = 0.05. The response rate was 84%. Ocular accidents were reported by 73% of the participants. Amalgam and NaOCl were the foreign bodies most frequently associated with ocular accidents. Medical assistance was sought in 16% of the most recent accidents. No permanent eye damage was reported. Regular use of magnification (OR:0.305, 95%CI:0.123-0.754) and years of clinical experience (OR:0.191, 95%CI:0.066-0.551) were significant predictors for the incidence of ocular accidents. Adequate eye protection was utilized by 82% of endodontists. Endodontists with eyesight deficiencies attended more frequently for ocular examination (P = 0.018). A high percentage of endodontists experienced ocular accidents. Regular use of magnification and increasing years in practice were associated with a reduced risk of ocular accidents. The majority of endodontists reported using adequate eye protection. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.
Janya, Suma; Gubrellay, Priyanka; Purwar, Anupam; Khanna, Shally
Ocular defects result from tumor, congenital anomaly and external injury not only lead to serious impairment of function and esthetics but also make the patient psychologically disabled. Prosthetic rehabilitation attempts to restore these disfgurements may improve esthetic, level of function, general psychologic improvement and quality of life. This clinical report details an attempt to rehabilitate a pediatric patient who has undergone orbital enucleation resulting from retinoblastoma with the aid of custom ocular prosthesis using commercially available prefabricated eye shell. How to cite this article: Janya S, Gubrellay P, Purwar A, Khanna S. Prosthetic Rehabilitation of Ocular Defect resulting from Pediatric Retinoblastoma. Int J Clin Pediatr Dent 2014; 7(3):209-212.
Marshall, T.C.; Hahn, F.F.; Merickel, B.S.; Hobbs, C.H.
Three commercial formulations of 2,2,2-trifluoroethanol (TFE) were applied to eyes of rabbits and evaluated for their potential to cause ocular damage. All three products were severe eye irritants and water irrigation shortly after exposure was not effective in reducing ocular damage. Gross and histological observations revealed marked conjunctivitis, moderate to severe ulcerative keratitis, and hyperemia and edema of the iris, all of which showed evidence of resolution over the three-week course of investigation. However, complete reversal of all effects was not attained. TFE and its commercial formulations should be viewed as potentially severe human ocular irritants.
Flavio Mac Cord Medina
Full Text Available Kabuki syndrome is a rare congenital anomaly, characterized by five fundamental features, the "Pentad of Niikawa": dysmorphic facies, skeletal anomalies, dermatoglyphic abnormalities, mild to moderate mental retardation and postnatal growth deficiency. Patients present characteristic external ocular features, nonetheless they may also present significant ocular abnormalities. We report a case of a brazilian child diagnosed with Kabuki syndrome, addressing the clinical features observed, with emphasis on the ocular manifestations. This case highlights the existence of this syndrome and all of its complexity. The identification of preventable causes of loss of vision underlines the value of detailed ophthalmologic examination of Kabuki syndrome patients.
Jeffrey L. Jones; Holland, Gary N.
Toxoplasmosis is the most common retinal infection in the United States, and it can severely impact vision. We used data from population-based studies, outbreaks, and the U.S. census to estimate the burden of Toxoplasma gondii infection and ocular toxoplasmosis. We estimate that 1,075,242 persons are infected with T. gondii, 21,505 persons have ocular lesions (both asymptomatic and symptomatic), and 4,839 (range = 2,150–7,527) persons develop symptomatic ocular toxoplasmosis each year in the ...
Ying Ting Chen
Full Text Available Keratinizing squamous metaplasia (SQM of the ocular surface is a blinding consequence of systemic autoimmune disease and there is no cure. Ocular SQM is traditionally viewed as an adaptive tissue response during chronic keratoconjunctivitis sicca (KCS that provokes pathological keratinization of the corneal epithelium and fibrosis of the corneal stroma. Recently, we established the autoimmune regulator-knockout (Aire KO mouse as a model of autoimmune KCS and identified an essential role for autoreactive CD4+ T cells in SQM pathogenesis. In subsequent studies, we noted the down-regulation of paired box gene 6 (Pax6 in both human patients with chronic KCS associated with Sjögren's syndrome and Aire KO mice. Pax6 encodes a pleiotropic transcription factor guiding eye morphogenesis during development. While the postnatal function of Pax6 is largely unknown, we hypothesized that its role in maintaining ocular surface homeostasis was disrupted in the inflamed eye and that loss of Pax6 played a functional role in the initiation and progression of SQM. Adoptive transfer of autoreactive T cells from Aire KO mice to immunodeficient recipients confirmed CD4+ T cells as the principal downstream effectors promoting Pax6 downregulation in Aire KO mice. CD4+ T cells required local signaling via Interleukin-1 receptor (IL-1R1 to provoke Pax6 loss, which prompted a switch from corneal-specific cytokeratin, CK12, to epidermal-specific CK10. The functional role of Pax6 loss in SQM pathogenesis was indicated by the reversal of SQM and restoration of ocular surface homeostasis following forced expression of Pax6 in corneal epithelial cells using adenovirus. Thus, tissue-restricted restoration of Pax6 prevented aberrant epidermal-lineage commitment suggesting adjuvant Pax6 gene therapy may represent a novel therapeutic approach to prevent SQM in patients with chronic inflammatory diseases of the ocular surface.
Full Text Available Michael S Korenfeld,1,2 David K Dueker3 1Comprehensive Eye Care, Ltd. Washington, MO, USA; 2Washington University Department of Ophthalmology and Visual Sciences, St Louis, MO, USA; 3Ophthalmology, Hamad Medical Corporation, Doha, Qatar Purpose: The authors have previously validated an Ocular Pressure Estimator (OPE that can estimate the intraocular pressure (IOP during external ocular compression (EOC. The authors now apply the OPE in clinical states where EOC is clinically important. The original work is described for two periods of risk: during sleep and during the digital ocular massage (DOM maneuver used by surgeons after trabeculectomy to keep the operation functional. Other periods of risk for external ocular compression are then reviewed.Methods: The first protocol estimated the IOP in the dependent eye during simulated sleep. Subjects had their IOPs initially measured in an upright-seated position, immediately upon assuming a right eye dependent side sleeping position (with nothing contacting the eye, and then 5 minutes later while still in this position. While maintaining this position, the fluid filled bladder of the OPE was then placed between the subject’s closed eye and a pillow during simulated sleep. The IOP was continuously estimated in this position for 5 minutes. The subjects then had the IOP measured in both eyes in an upright-seated position. The second protocol determined if a larger vertical cup-to-disc ratio was more common on the side that patients reported they preferred to sleep on. The hypothesis was that chronic asymmetric, compression induced, elevations of IOP during sleep would be associated with otherwise unexplained asymmetry of the vertical cup-to-disc ratio. The third protocol assessed the IOP during DOM. The OPE was used to characterize the IOP produced during the DOM maneuver of five glaucoma surgeons. After this, 90 mmHg was chosen as a target pressure for DOM. The surgeons were then verbally coached
Yang, Shun-nan; Tai, Yu-chi; Sheedy, James E; Kinoshita, Beth; Lampa, Matthew; Kern, Jami R
To help maintain clear vision and ocular surface health, eye blinks occur to distribute natural tears over the ocular surface, especially the corneal surface. Contact lens wearers may suffer from poor vision and dry eye symptoms due to difficulty in lens surface wetting and reduced tear production. Sustained viewing of a computer screen reduces eye blinks and exacerbates such difficulties. The present study evaluated the wetting effect of lens care solutions (LCSs) on blink rate, dry eye symptoms, and vision performance. Sixty-five adult habitual soft contact lens wearers were recruited to adapt to different LCSs (Opti-free, ReNu, and ClearCare) in a cross-over design. Blink rate in pictorial viewing and reading (measured with an eyetracker), dry eye symptoms (measured with the Ocular Surface Disease Index questionnaire), and visual discrimination (identifying tumbling E) immediately before and after eye blinks were measured after 2 weeks of adaption to LCS. Repeated measures anova and mixed model ancova were conducted to evaluate effects of LCS on blink rate, symptom score, and discrimination accuracy. Opti-Free resulted in lower dry eye symptoms (p = 0.018) than ClearCare, and lower spontaneous blink rate (measured in picture viewing) than ClearCare (p = 0.014) and ReNu (p = 0.041). In reading, blink rate was higher for ClearCare compared to ReNu (p = 0.026) and control (p = 0.024). Visual discrimination time was longer for the control (daily disposable lens) than for Opti-Free (p = 0.007), ReNu (p = 0.009), and ClearCare (0.013) immediately before the blink. LCSs differently affected blink rate, subjective dry eye symptoms, and visual discrimination speed. Those with wetting agents led to significantly fewer eye blinks while affording better ocular comfort for contact lens wearers, compared to that without. LCSs with wetting agents also resulted in better visual performance compared to wearing daily disposable contact lenses. These presumably are because of
Conclusion: Any minimal angle of head tilt may cause erroneous measurement of astigmatic axis and should be avoided during refraction. One cannot rely on the compensatory function of ocular counter-torsion during the refraction.
T Ashwini Kini
Full Text Available Progressive hemifacial atrophy (PHA is a disease of unknown etiology affecting one-half of the face. Ocular involvement is uncommon. Atrophy of iris is rare, with only a few cases of partial atrophy being reported in the literature. We report a case of total atrophy of iris and ciliary body with associated ocular hypotony in a 16-year-old girl with PHA. We believe this is the first reported case of complete atrophy of iris and ciliary body in PHA. Ocular hypotony in PHA was thought to be due to intra-ocular inflammation. However in our case it appears to be secondary to severe atrophy of the ciliary body.
Palamar, Melis; Egrilmez, Sait; Yilmaz, Suzan Guven; Polat, Suleyha Hilmioglu; Gunduz, Omur Ucakhan
Systemic voriconazole treatment was reported to cause photosensitivity and related cutaneous malignancies. The aim of this report is to demonstrate a graft-related Candida endophthalmitis case that developed ocular surface dysplastic changes after receiving topical 1% voriconazole treatment. Full ocular examination, photography, and in vivo confocal microscopy examination (Rostock Cornea Module/HRT II, Heidelberg, Germany) were performed. A 73-year-old male with graft-related Candida endophthalmitis that was on topical 1% voriconazole for 4 months developed a whitish gelatinous lesion on the cornea originating from the nasal limbus. In vivo confocal microscopy examination revealed mild dysplastic changes in the cornea epithelium. Topical voriconazole might trigger neoplastic changes on the ocular surface as reported with systemic use in other sun-exposed parts of the body. Further studies are needed to relate topical use of voriconazole with ocular surface dysplasia.
Full Text Available We report successful outcome of a huge post- trabeculectomy intra-bleb hematoma and hyphema that occurred following digital ocular compression. The patient was a 64-year-old lady suffering from bilateral primary angle closure glaucoma and cataract. She was on anti-platelet therapy. She underwent single-site phacoemulsification, intra-ocular lens implantation and trabeculectomy with mitomycin C in the right eye. The trabeculectomy was under-filtering. She was asked to perform digital ocular compression thrice daily. On 15 th post-operative day, she presented with a huge intra-bleb hematoma and hyphema. The hematoma did not respond to conservative measures and was drained to prevent bleb failure. We recommend caution in the consideration of digital ocular compression in patients on prophylactic anti-coagulation.
Full Text Available Paintball is a popular recreational sport. This case series describes three Saudi patients exposed to paintball ocular injuries with sever ocular trauma. Two patients developed hyphema and traumatic cataract and one patient had vitreous hemorrhage, choroidal detachment, commotio retinae and retinal tear. All patients require surgical intervention. Final best corrected visual acuity was 20/200, 20/30 and 20/50 respectively. Paintball related ocular injuries can result in severe visual loss and in most of the time requires surgical intervention. Most injuries occur in under-supervised settings and are easily preventable. Our main aim was to increase awareness among local ophthalmologists and eye professionals about this new game. Improved safety measures and appropriate public education could prevent such serious ocular injuries.
Al-Amry, Mohammad; Al-Ghadeer, Huda
Paintball is a popular recreational sport. This case series describes three Saudi patients exposed to paintball ocular injuries with sever ocular trauma. Two patients developed hyphema and traumatic cataract and one patient had vitreous hemorrhage, choroidal detachment, commotio retinae and retinal tear. All patients require surgical intervention. Final best corrected visual acuity was 20/200, 20/30 and 20/50 respectively. Paintball related ocular injuries can result in severe visual loss and in most of the time requires surgical intervention. Most injuries occur in under-supervised settings and are easily preventable. Our main aim was to increase awareness among local ophthalmologists and eye professionals about this new game. Improved safety measures and appropriate public education could prevent such serious ocular injuries.
Elaeis guineensis), and is widely consumed among the various ethnic nationalities in Nigeria. The effect of bolus ingestion of 600ml, palm wine was undertaken so as to determine its ocular dynamics in healthy volunteers. Results showed that ...
Reeves, Graham M B; Lloyd, Marianne; Rajlawat, Bijaya P; Barker, Gillian L; Field, E Anne; Kaye, Stephen B
A variety of methods have been described for grading ocular mucous membrane pemphigoid (MMP), each with their own limitations. In contrast, there are no reported grading systems for involvement of the oral mucosa. We wished to evaluate two ocular (one established and one proposed) and an oral mucosal grading system for MMP. Patients with MMP were assessed by three ophthalmologists and two oral medicine physicians. Ocular disease was graded using the system described by Rowsey and a proposed system based on measurement of vertical depth and horizontal width measured from the bulbar conjunctival aspect. Oral assessment used a 'mucosal disease severity score' originally described for lichen planus, in which 17 areas of the mouth are scored for involvement, together with a pain score. Levels of agreement were evaluated using Fleiss' Kappa Statistic (k). Forty-four patients with MMP encompassing mild to severe disease were included. Good levels of agreement were observed between observers for both vertical (k:0.86) (upper 95% CI: 1.03 mm) and horizontal (k:0.80) (upper 95% CI: 3.01 mm) involvement for the proposed ocular system and the Rowsey system (k: 0.83) (upper 95% confidence interval: 3.19 mm). There was a high coefficient of determination (R(2)) between the ocular grading systems (0.81, p < 0.01). Oral grading showed excellent levels of agreement (k: 0.71) between observers. There was no significant association between the severity of oral and ocular disease using described grading systems. The proposed grading systems for both oral and ocular involvement in MMP are easy to use, and show good agreement between observers. The proposed ocular system correlates well with a currently used system, and overcomes some of the difficulties encountered with existing systems. For the individual patient, changes greater than 1.5 mm (vertical) and 3 mm (horizontal) are significant. This may increase our ability to detect change or disease progression. Although the
Ebru Demet Aygıt; Zeynep Alkın; Birsen Gökyiğit; Hülya Güngel; Ahmet Demirok
Objectives: To evaluate ocular biometric parameters including anterior chamber depth (ACD), corneal curvature (CC), central corneal thickness (CCT), horizontal corneal diameter, and corneal biomechanical properties using ocular response analyzer (ORA) in eyes with hypermetropic anisometropia and to compare the results with those obtained for the healthy eyes of the patients. Materials and Methods: Sixty-four eyes of 32 patients followed with the diagnosis of hypermetropic anisometrop...
Behera, Umesh Chandra; Panda, Lapam; Gupta, Sumi; Modi, Rohit Ramesh
To report two cases of retinal vascular occlusion and associated subconjunctival hemorrhage in needle optic nerve injury during local bulbar anesthesia. Surgical records of these two subjects who presented with acute vision loss after cataract extraction were studied, and systemic workup and ocular imaging were carried out to establish the cause. Computerized tomography showed evidence of optic nerve injury. Subconjunctival hemorrhage could be an associated clinical finding in hypodermic needle injury-related retinal vascular occlusion during ocular anesthesia.
Full Text Available BACKGROUND : Dermatologic disorders usually have manifestations which involve the eyelids, conjunctiva, and cornea. The ocular complications may often be the most devastating outcome for survivors of the acute reaction. The key to success to minimize possibility of visual impairment is the prevention of complications. OBJECTIVES: This study highlights the ocular manifestations of various mucocutaneous disorders. MATERIALS AND METHOD S: A prospective study was conducted in the Department of Ophthalmology in a medical college hospital, over a period of 1 year, on patients presenting with mucocutaneous syndromes who were referred from the Departments of Dermatology and Medicine. Patients with co - morbid diseases like diabetes and hypertension wherein ocular involvement is likely were excluded from the study. RESULTS: In this study, 103 patients with mucocutaneous disorders were examined, of which 65 (63.1% had ocular involvement. Majority of the patients belonged to the 21 - 30 years age group; with a male preponderance. The most common mucocutaneous syndrome in this study was herpes (37%, followed by leprosy (27%. Ocular involvement was seen in 69% patients with herpes and 79% patients with leprosy. In this study, periorbital vesicles was the most common ocular manifestation in herpes (20%, followed by blepharitis, conjunctivitis, corneal epithelial defect and keratitis; however, in leprosy, madarosis (16% was the commonest ocular lesion. Economic blindness (visual acuity <6/60 was seen in 6 cases, and visual handicap (visual acuity <6/18 in 20 cases. The most common cause of visual impairment was due to corneal implications. Over the course of next three months, 19 patients (25% developed various ocular complications like dry eye (10%, corneal scar (5%, corneal vascularisation (3%, trichiasis (3%, symblepharon (8%, and ankyloblepharon (15%. CONCLUSION: Careful ophthalmic examinations during the early period of the skin reaction and early
Barar, Jaleh; Aghanejad, Ayuob; Fathi, Marziyeh; Omidi, Yadollah
Introduction: Ocular targeted therapy has enormously been advanced by implementation of new methods of drug delivery and targeting using implantable drug delivery systems (DDSs) or devices (DDDs), stimuli-responsive advanced biomaterials, multimodal nanomedicines, cell therapy modalities and medical bioMEMs. These technologies tackle several ocular diseases such as inflammation-based diseases (e.g., scleritis, keratitis, uveitis, iritis, conjunctivitis, chorioretinitis, choroiditis, retinitis...
Full Text Available BACKGROUND The study aims to determine the prevalence of ocular manifestations in quarry workers in Puducherry. Quarry workers are at high risk of developing pterygium, dry eye, ocular injuries, scleral pigmentation, nonspecific inflammation, irritation and watering. Quarry work accounts for the highest rate of injury amongst industrial work and the safety awareness is poor amongst the workers. MATERIALS AND METHODS A cross-sectional study involving 254 quarry workers was conducted between March 2015 and September 2015. A structured questionnaire was used to obtain information on demographics, ocular symptoms, ocular injury and use of protective wear during work. Slit lamp examination was done to detect ocular surface disorders like pterygium. Schirmer’s test was done for the detection of dry eye. Pterygium and dry eye were graded based on the severity. RESULTS Among quarry work, the ocular manifestations included pterygium (57.48%, dry eye (46.6%, inflamed eyes (18.5% and scleral pigmentation (57.48%. The workers were subdivided based on the severity of pterygium (Grade I - 49.80%, Grade II - 6.49%, Grade III - 1.37% and based on the severity of dry eye (mild - 18.11%, moderate - 13.85%, severe - 9.05% and very severe - 5.09%. The awareness about hazards and safety precautions to be followed are poor among quarry workers. Most of them fail to use protective measures during work. CONCLUSION The study shows a definite predilection for pterygium, dry eye and ocular injuries in quarry workers. Awareness of such morbidity and use of safety measures would improve ocular health.
Venkata Madusudanarao Kanukollu
Full Text Available BACKGROUND Ocular trauma is a major cause of preventable ocular blindness in the world. The present available data represents the tip of iceberg. The data pertaining to ocular trauma is just hospital based data which does not accurately represent the population at risk. The ocular morbidity may be disproportionate to the severity of injury. Though eyes represent only 0.21% of body surface area and 4% of facial area, they are the third most common trauma exposed areas after hands and feet. MATERIALS AND METHODS Our study group consisted of 341 patients who attended ophthalmology OPD with history of ocular trauma of whom 221 were males and 121 were females. The study was conducted over a period of one year. A complete anterior and posterior segment evaluation of all the patients was done. Other accessory ocular and systemic investigations wherever essential were done. RESULTS The ocular trauma was more common in males (64.52% predominantly affecting patients of 20-40 years age group (36.07%. Most often the injuries were occupation related (73.90% and the most common work related injury observed was extraocular foreign body in 134 patients (39.29%. Closed globe injuries were more common as compared to open globe injuries. Eyes with better visual acuity at presentation had better visual prognosis. Blinding trauma was observed in 29 patients (8.50%. CONCLUSION Ocular injuries are more commonly occupation related and mostly effect young males who are the main work force of our society. Stringent implementation of preventive norms in industries to all the workers and safety precautions during sports, driving need to be enforced.
Indicator for Concomitant Ocular Injury Sb. GRANT NUMBER Sc. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Sd. PROJECT NUMBER Capt Santamaria, Joseph Se. TASK...NOTES Society of Military Ophthalmologists, New Orleans, LA, Nov 12th, 2017 14. ABSTRACT Title: Orbital Roof Fractures as an Indicator for...7.0 Title: Orbital Roof Fractures as an Indicator for Concomitant Ocular Injury Authors: Joseph Santamaria MD, Aditya Mehta MD, Donovan Reed MD
Stahl, John S; Thumser, Zachary C; May, Paul J; Andrade, Francisco H; Anderson, Sean R; Dean, Paul
Rigorous descriptions of ocular motor mechanics are often needed for models of ocular motor circuits. The mouse has become an important tool for ocular motor studies, yet most mechanical data come from larger species. Recordings of mouse abducens neurons indicate the mouse mechanics share basic viscoelastic properties with larger species but have considerably longer time constants. Time constants can also be extracted from the rate at which the eye re-centers when released from an eccentric position. The displacement can be accomplished by electrically stimulating ocular motor nuclei, but electrical stimulation may also activate nearby ocular motor circuitry. We achieved specific activation of abducens motoneurons through photostimulation in transgenic mice expressing channelrhodopsin in cholinergic neurons. Histology confirmed strong channelrhodopsin expression in the abducens nucleus with relatively little expression in nearby ocular motor structures. Stimulation was delivered as 20- to 1,000-ms pulses and 40-Hz trains. Relaxations were modeled best by a two-element viscoelastic system. Time constants were sensitive to stimulus duration. Analysis of isometric relaxation of isolated mouse extraocular muscles suggest the dependence is attributable to noninstantaneous decay of active forces in non-twitch fibers following stimulus offset. Time constants were several times longer than those obtained in primates, confirming that the mouse ocular motor mechanics are relatively sluggish. Finally, we explored the effects of 0.1- to 20-Hz sinusoidal photostimuli and demonstrated their potential usefulness in characterizing ocular motor mechanics, although this application will require further data on the temporal relationship between photostimulation and neuronal firing in extraocular motoneurons.
Full Text Available Osmo Kari1, K Matti Saari21Department of Allergology, Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland; 2Department of Ophthalmology, University of Turku, Turku, FinlandAbstract: Allergic diseases have greatly increased in industrialized countries. About 30% of people suffer from allergic symptoms and 40%–80% of them have symptoms in the eyes. Atopic conjunctivitis can be divided into seasonal allergic conjunctivitis (SAC and perennial allergic conjunctivitis (PAC. The treatment of SAC is simple; antihistamines, anti-inflammatory agents, or chromoglycate. In severe cases of SAC, subcutaneous or sublingual immunotherapy is helpful. PAC needs longer therapy, often year round, with mast cell stabilizers, antihistamines, and sometimes local steroids. Atopic keratoconjunctivitis is a more severe disease showing chronic blepharitis often connected with severe keratitis. It needs, in many cases, continuous treatment of the lid eczema and keratoconjunctivitis. Blepharitis is treated with tacrolimus or pimecrolimus ointment. Conjunctivitis additionally needs corticosteroids and, if needed, cyclosporine A (CsA drops are administered for longer periods. Basic conjunctival treatment is with mast cell-stabilizing agents and in addition, antihistamines are administered. Vernal keratoconjunctivitis is another chronic and serious allergic disease that mainly affects children and young people. It is a long-lasting disease which commonly subsides in puberty. It demands intensive therapy often for many years to avoid serious complicating corneal ulcers. Treatment is mast cell-stabilizing drops and additionally antihistamines. In relapses, corticosteroids are needed. When the use of corticosteroids is continuous, CsA drops should be used, and in relapses, corticosteroids should be used additionally. Nonallergic eosinophilic conjunctivitis (NAEC is a less known, but rather common, ocular disease. It affects mostly middle-aged and
Kambhampati, Siva Pramodh
PAMAM dendrimers are a class of well-defined, hyperbranched polymeric nanocarriers that are being investigated for ocular drug and gene delivery. Their favorable properties such as small size, multivalency and water solubility can provide significant opportunities for many biologically unstable drugs and allows potentially favorable ocular biodistribution. This work exploits hydroxyl terminated dendrimers (G4-OH) as drug/gene delivery vehicles that can target retinal microglia and pigment epithelium via systemic delivery with improved efficacy at much lower concentrations without any side effects. Two different drugs Triamcinolone acetonide (TA) and N-Acetyl Cysteine (NAC) conjugated to G4-OH dendrimers showed tailorable sustained release in physiological relevant solutions and were evaluated in-vitro and in-vivo. Dendrimer-TA conjugates enhanced the solubility of TA and were 100 fold more effective at lower concentrations than free TA in its anti-inflammatory activity in activated microglia and in suppressing VEGF production in hypoxic RPE cells. Dendrimers targeted activated microglia/macrophages and RPE and retained for a period of 21 days in I/R mice model. The relative retention of intravitreal and intravenous dendrimers was comparable, if a 30-fold intravenous dose is used; suggesting intravenous route targeting retinal diseases are possible with dendrimers. D-NAC when injected intravenously attenuated retinal and choroidal inflammation, significantly reduced (˜73%) CNV growth at early stage of AMD in rat model of CNV. A combination therapy of D-NAC + D-TA significantly suppressed microglial activation and promoted CNV regression in late stages of AMD without causing side-effects. G4-OH was modified with linker having minimal amine groups and incorporation of TA as a nuclear localization enhancer resulted in compact gene vectors with favorable safety profile and achieved high levels of transgene expression in hard to transfect human retinal pigment
A. M. Kolomeyer
Full Text Available Purpose. To describe integration of fundus autofluorescence (FAF imaging into an ocular screening program. Methods. Fifty consecutive screening participants were included in this prospective pilot imaging study. Color and FAF (530/640 nm exciter/barrier filters images were obtained with a 15.1MP Canon nonmydriatic hybrid camera. A clinician evaluated the images on site to determine need for referral. Visual acuity (VA, intraocular pressure (IOP, and ocular pathology detected by color fundus and FAF imaging modalities were recorded. Results. Mean ± SD age was 47.4 ± 17.3 years. Fifty-two percent were female and 58% African American. Twenty-seven percent had a comprehensive ocular examination within the past year. Mean VA was 20/39 in the right eye and 20/40 in the left eye. Mean IOP was 15 mmHg bilaterally. Positive color and/or FAF findings were identified in nine (18% individuals with diabetic retinopathy or macular edema (n=4, focal RPE defects (n=2, age-related macular degeneration (n=1, central serous retinopathy (n=1, and ocular trauma (n=1. Conclusions. FAF was successfully integrated in our ocular screening program and aided in the identification of ocular pathology. Larger studies examining the utility of this technology in screening programs may be warranted.
Haring, R Sterling; Sheffield, Isaac D; Channa, Roomasa; Canner, Joseph K; Schneider, Eric B
Determining the national epidemiologic trends of chemical ocular burns can assist physicians and policy makers in appropriate allocation of resources for treatment and prevention. To describe the epidemiologic trends and risk factors for chemical burns of the eye. Between August 1, 2015, and April 25, 2016, data from the Nationwide Emergency Department Sample were analyzed from January 1, 2010, through December 31, 2013. A sample of 900 emergency departments (EDs) across the United States was used. Patients presenting to EDs with a diagnosis of alkali or acid ocular burn, chemical conjunctivitis, or a combination of nonspecific ocular chemical burn and chemical poisoning or toxic effects were eligible for inclusion. Injured patients' age, sex, primary health care insurance, income quartile, and other demographics were described. A subset consisting of those injuries identified as alkaline or acidic burns was further characterized. Age-specific rates of ED presentation for chemical ocular burn injuries, independent factors associated with all, alkali, and acid injuries, and total ED-associated charges. From January 1, 2010, through December 31, 2013, a total of 144 149 chemical ocular burns were diagnosed at EDs nationwide. Men represented 56.6% of all cases (n = 81 496). Median age was 32 years, with female patients presenting at a younger age than male patients (median of 32 vs 34 years; P ocular chemical injuries. Education and other interventions concerned with preventing these injuries will be most effective if used accordingly.
Bauskar, Aditi; Mack, Wendy J; Mauris, Jerome; Argüeso, Pablo; Heur, Martin; Nagel, Barbara A; Kolar, Grant R; Gleave, Martin E; Nakamura, Takahiro; Kinoshita, Shigeru; Moradian-Oldak, Janet; Panjwani, Noorjahan; Pflugfelder, Stephen C; Wilson, Mark R; Fini, M Elizabeth; Jeong, Shinwu
Dry eye is a common disorder caused by inadequate hydration of the ocular surface that results in disruption of barrier function. The homeostatic protein clusterin (CLU) is prominent at fluid-tissue interfaces throughout the body. CLU levels are reduced at the ocular surface in human inflammatory disorders that manifest as severe dry eye, as well as in a preclinical mouse model for desiccating stress that mimics dry eye. Using this mouse model, we show here that CLU prevents and ameliorates ocular surface barrier disruption by a remarkable sealing mechanism dependent on attainment of a critical all-or-none concentration. When the CLU level drops below the critical all-or-none threshold, the barrier becomes vulnerable to desiccating stress. CLU binds selectively to the ocular surface subjected to desiccating stress in vivo, and in vitro to the galectin LGALS3, a key barrier component. Positioned in this way, CLU not only physically seals the ocular surface barrier, but it also protects the barrier cells and prevents further damage to barrier structure. These findings define a fundamentally new mechanism for ocular surface protection and suggest CLU as a biotherapeutic for dry eye.
Bauskar, Aditi; Mack, Wendy J.; Mauris, Jerome; Argüeso, Pablo; Heur, Martin; Nagel, Barbara A.; Kolar, Grant R.; Gleave, Martin E.; Nakamura, Takahiro; Kinoshita, Shigeru; Moradian-Oldak, Janet; Panjwani, Noorjahan; Pflugfelder, Stephen C.; Wilson, Mark R.; Fini, M. Elizabeth; Jeong, Shinwu
Dry eye is a common disorder caused by inadequate hydration of the ocular surface that results in disruption of barrier function. The homeostatic protein clusterin (CLU) is prominent at fluid-tissue interfaces throughout the body. CLU levels are reduced at the ocular surface in human inflammatory disorders that manifest as severe dry eye, as well as in a preclinical mouse model for desiccating stress that mimics dry eye. Using this mouse model, we show here that CLU prevents and ameliorates ocular surface barrier disruption by a remarkable sealing mechanism dependent on attainment of a critical all-or-none concentration. When the CLU level drops below the critical all-or-none threshold, the barrier becomes vulnerable to desiccating stress. CLU binds selectively to the ocular surface subjected to desiccating stress in vivo, and in vitro to the galectin LGALS3, a key barrier component. Positioned in this way, CLU not only physically seals the ocular surface barrier, but it also protects the barrier cells and prevents further damage to barrier structure. These findings define a fundamentally new mechanism for ocular surface protection and suggest CLU as a biotherapeutic for dry eye. PMID:26402857
Al-Mahrouqi, Haitham H; Al-Harthi, Naila; Al-Wahaibi, Maryam; Hanumantharayappa, Kishore
To describe the epidemiology of ocular trauma in a tertiary hospital setting in Muscat, Oman. Medical records of all cases of ocular trauma which presented to the Emergency Department at Al-Nahdha Hospital and were seen by the ophthalmology service from January 1, 2013 to June 30, 2013 (6 months) were reviewed to collect data on ocular trauma according to the World Eye Injury Registry initial reporting form which uses the Birmingham Eye Trauma Terminology System. There were 27,951 patients seen at the Emergency Department and 611 of which were ocular trauma cases (cumulative incidence 2.2% [confidence interval 2.0-2.4]). The mean age of the patients was 23 years and males comprised the majority of the cases (72%). Thirty-two patients had bilateral injury giving a total of 643 eyes injured. More than half of all injuries were caused by either blunt or large sharp objects. The cornea was the most frequently injured tissue (49%), but most injuries were minor in nature. More than three quarters (77%) of all eyes had a visual acuity of 0.3 (LogMAR) or better on presentation. There were 35 eyes (6%) with open globe injuries (OGI) and three-quarters of them occurring in the manual laborers. Ocular trauma is a common presentation at Al-Nahdha Hospital. Although the majority of trauma cases were minor without any visual disability sequelae, OGI could have been prevented with better ocular protection in the workplace.
Keles, Sadullah; Ondas, Osman; Ekinci, Metin; Sener, Mustafa Talip; Erhan, Erim; Sirinkan, Ahmet; Akyol Salman, Ilknur; Kocer, Ibrahim; Baykal, Orhan
The aim of this study is to describe the type and severity of paintball-related ocular trauma and to determine the necessary precautions to minimize the risk of ocular injury regardless of whether adequate eye protection was used. A retrospective chart review identified patients treated for paintball-related ocular trauma at the Ataturk University Medical Hospital from June 2010 through March 2013. A descriptive analysis of data was performed. Ten patients with paintball-related ocular trauma were identified. At the time of their first examination, 7 of these patients had visual acuity (VA) of 20/200 or worse. One patient had a final VA of no light perception and 4 patients had a final VA of 20/200 or worse. Hyphema was noted in 7 patients, traumatic cataract in 2, iridodialysis in 2, retinal detachment in 3, and secondary glaucoma in 1. Six patients required surgery. Although all victims have used eye protection during the game, all patients were injured after they thought the game was over and had taken off their helmets or eye-protective devices. Paintball-related accidents result in serious ocular trauma and most of the patients require surgery. These injuries result in severe loss of VA in some patients. Uninterrupted use of proper eye protection whenever a player is in the game field, even after they believe the game has ended, may reduce the incidence of severe ocular trauma in paintball players.
Bäuerle, Jochen; Gross, Nikolai J; Egger, Karl; Neubauer, Jakob; Niesen, Wolf-Dirk; Buttler, Klaus-Jürgen; Lagrèze, Wolf A; Reinhard, Matthias
To assess the accuracy of ocular B-mode sonography and of standard head computed tomography (CT) as screening tools for intraocular hemorrhages related to subarachnoid hemorrhage (SAH). 46 patients with spontaneous SAH were examined using ocular B-mode sonography and underwent funduscopy as gold standard for detection of ocular hemorrhages (OH). Additionally, all head CT scans done during the hospital stay of the study population were rated by a neuroradiologist for the presence of OH. Funduscopy revealed vitreous and/or preretinal hemorrhages in ten eyes and retinal hemorrhages in nine eyes. In comparison with funduscopy, ocular sonography showed a sensitivity and specificity for the detection of vitreous and/or preretinal hemorrhages of 100%, while identification of retinal hemorrhages was less reliable with a sensitivity/specificity of 44%/100%. Standard head CT showed a lower sensitivity/specificity of 60%/96% for vitreous and/or preretinal hemorrhages, and 32%/95% for the diagnosis of any ocular bleeding. Ocular sonography identifies SAH-related preretinal and vitreous hemorrhages with high accuracy and is superior to standard head CT. It may be considered as new and useful bedside diagnostic tool for routine clinical care of patients with SAH. Copyright © 2015 by the American Society of Neuroimaging.
Pant, Mukund; Shrestha, Gauri Shankar; Joshi, Niraj Dev
Prevalence of ocular morbidity among street children is largely unknown. The present study was carried out to determine the prevalence of ocular morbidity among street children in the Kathmandu Valley. A cross-sectional study consisting of an eye examination program among 569 street children aged younger than 18 years was conducted from March 2013 to February 2014. Children were included from 11 safe houses of 6 non-governmental organizations and an independent eye camp. Eye examination included visual acuity testing, anterior segment and posterior segment examination, retinoscopy and refraction, cover test, convergence, accommodation and color vision tests. Chi-square test was used to analyze the association of ocular morbidity with age, sex and living conditions. The majority of children (43.8%) were in the age group of 12-15 years, and the male to female ratio was 3.9:1. Uncorrected and best-corrected visual acuity ≥6/9 in at least one eye was found in 89.8% and 98.4% of children, respectively. Total ocular morbidity was observed at 31.6%. The most common types of ocular morbidity were conjunctivitis (11.0%) and refractive error (11.6%). Ocular morbidity was more common in children over 15 years of age (40.9%; p morbidities in street children in the Kathmandu Valley.
Chiotan, C; Radu, L; Serban, R; Cornăcel, C; Cioboată, M; Anghelie, A
Human immunodeficiency virus (HIV) has the ability to affect any organ in the body. In 70% of HIV -infected patients ocular manifestations were observed, these, in the vast majority reflect the systemic disease and may be the first signs of disseminated infections. The purpose of this paper is to determine the prevalence of posterior segment ocular manifestations in HIV / AIDS (Acquired Immunodeficiency Syndrome) patients. The study is retrospective, conducted in the Cabinet of Ophthalmology of "Matei Bals" Infectious Diseases Hospital in Bucharest, during the period 1 August 2007 - 1 August 2013 . Each patient was examined thoroughly at the biomicroscope ocular slit by using 90D microscope lens and 20D indirect lens after the administration of topical mydriatics. 348 patients with HIV/AIDS and ocular disorders were followed. There was a high number of children and young people with HIV who had eye disorders (194 patients aged between 14 and 25 years). 44.25% of patients had posterior segment ocular damage, 17.55% of them had the anterior segment affected. 22.90% of the 131 patients with compromised posterior segment microangiopathy have been diagnosed with HIV / AIDS. Doctors should be aware of the existence of ocular damage in HIV / AIDS and to emphasize the importance of regular ophthalmologic examination of patients with HIV / AIDS.
Frings, Andreas; Katz, Toam; Steinberg, Johannes; Druchkiv, Vasyl; Richard, Gisbert; Linke, Stephan J
To analyze the influence of demographic and ocular factors on ocular residual astigmatism (ORA) in myopic laser in situ keratomileusis (LASIK). University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Retrospective cross-sectional data analysis. Eyes of consecutive myopic patients scheduled for LASIK were studied to evaluate the influence on preexisting ORA of age, sex, ocular dominance, subjective cylinder and topographic astigmatism, subjective sphere, and mesopic pupil size. The ORA was determined using Alpins vector analysis. Two subgroups, defined by the ratio of ORA to preoperative refractive cylinder (R), were formed: ORA:R ≥ 1.0 and ORA:R patients). The mean ORA was 0.75 diopter (D) ± 0.39 (SD) (range 0.00 to 2.00 D); 1372 (46%) eyes had ORA of 1.00 D or more. Ordinary least square estimations and odds ratios showed that subjective sphere, male sex, and dominant eye were negative predictors of the degree of preoperative ORA, while increasing age and larger mesopic pupils did not indicate ORA orientation. With-the-rule astigmatism meridian was more likely in eyes with low ORA, while oblique and against-the-rule meridians were related to high ORA. The preoperative assessment of refractive surgery candidates should consider the interaction between topographic, refractive, and ORA because corneal refractive surgery is more successful in eyes in which the cylinder mainly originates from the anterior cornea. The current data can help identify patients at high risk for having a significant difference between subjective cylinder and topographic astigmatism. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.
Mônica Fialho Cronemberger
Full Text Available Objetivo: Estudar as alterações oculares em pacientes com mielomeningocele. Material e Método: Realizado estudo retrospectivo em 72 pacientes com mielomeningocele, descrevendo as alterações oculares presentes nessa população, além de correlacionar com a presença ou não de hidrocefalia. Resultados: Dos 72 pacientes com mielomeningocele, com idade variando de 5 meses a 18 anos, 64 (88,9% pacientes tinham hidrocefalia. Destes 64 pacientes, 36 (56,3% tinham estrabismo, sendo que 21 (58,3% eram endotrópicos, 13 (36,1% exotrópicos, 1 (2,8% exofórico e 1 (2,8% com estrabismo discinético. Do total dos 72 pacientes estudados 38 (52,8% eram estrábicos. A anisotropia foi encontrada em 16 (22,2% pacientes, sendo que em 14 (87,5% em A e em 2 (12,5% em V. Todos os 16 pacientes com anisotropia apresentavam hidrocefalia. O erro refrativo mais freqüente foi a hipermetropia encontrada em 64 (44,4% olhos. Atrofia óptica foi encontrada em 9 (12,5% pacientes. Conclusão: A mielomeningocele, associada a hidrocefalia, apresenta uma porcentagem de estrabismo maior do que o encontrado na população normal.Purpose: To study ocular findings in patients with meningomyelocele. Methods: A retrospective study of 72 patients with myelomeningocele was performed to evaluate ocular motility disorders, refractive errors and indirect ophthalmoscopy findings. Results: In a group of 72 patients with myelomeningocele, aged 5 month -- 18 years, 64 (88.9% had hydrocephalus. Of this group of 64 patients, 36 (56.3% had strabismus, 21 (58.3% of whom were esotropic, and 13 (36.1% exotropic, 1 (2.8% exophoric and 1 (2.8% presented sometimes esotropia and sometimes exotropia. Of the total of 72 studied patients, 38 (52.8% had strabismus. Anisotropia was found in 16 (22.2% patients, 14 (87.5% with an A pattern and 2 (12.5% with a V pattern. The most frequent refractive error was hyperopia, found in 64 (44.4% eyes. All the 16 patients with anisotropia had hydrocephalus
Alexandre Mattoso Libório
Full Text Available OBJETIVO: Avaliar a presença de microbiota aeróbia da conjuntiva de portadores de alergia ocular e comparar a um grupo controle. MÉTODOS: Foram examinados 133 pacientes no período de abril a junho de 2001 divididos em 2 grupos. O grupo A foi composto de 63 portadores de conjuntivite alérgica (sem uso de medicação e o grupo B de 70 pacientes do ambulatório geral (controle. Foram coletadas amostras do fundo de saco conjuntival do olho direito de todos os pacientes e o material foi semeado em meios sólidos de cultura (ágar sangue, chocolate e Sabouraud. RESULTADOS: No grupo A, 30 culturas (47,7% foram positivas e no grupo B, 6 (8,6%. Sete bactérias foram isoladas no grupo A e 4 no B. A análise estatística revelou associação significante entre a positividade dos cultivos e conjuntivite alérgica. CONCLUSÃO: Microbiota bacteriana foi mais freqüentemente encontrada nos pacientes com alergia ocular.PURPOSE: To evaluate de presence of conjunctival aerobic microbiota in patients with ocular allergy as compared to a control group. METHODS: One hundred and thirty-three patients were evaluated from April to June 2001 and divided into 2 groups. Sixty-three patients with allergic conjunctivitis (without medication were in group A and 70 patients from the general outpatient clinic were in group B (control group. Samples from the conjunctival sac of the right eye were collected and cultured in solid media (blood, chocolate and Sabouraud agar. RESULTS: In group A, 30 cultures (47.7% were positive and 6 (8.6% in group B. Seven bacteria were isolated from group A and 4 from group B. Statistical analysis revealed significant association between positive cultures and allergic conjunctivitis. CONCLUSION: Bacterial microbiota was more frequently found in patients with ocular allergy.
De Masi, Franco
The delusional experience is the result of a grave disjunction in the psyche whose outcome is not readily predictable. Examination of the specific mode of disjunction may help us understand the nature and radical character of delusion. I will present the therapy of a psychotic patient who after many years of analysis and progresses in his life continues to show delusional episodes although limited and contained. In his case, the two visions, one delusional and the other real, remain distinct and differentiated from each other because they both possess the same perceptual character, that of reality. He has a bi-ocular vision of reality and not a binocular one because his vision lacks integration, as would necessarily be the case if the two visions could be compared with each other. The principle of non-contradiction ceases to apply in delusion. A corollary of the failure of the principle of non-contradiction is that, if a statement and its negation are both true, then any statement is true. Logicians call this consequence the principle of explosion. For this reason, the distinction between truth, reality, improbability, probability, possibility and impossibility is lost in the delusional system, thus triggering an omnipotent, explosive mechanism with a potentially infinite progression. The paper presents some thoughts for a possible analytic transformation of the delusional experience. Copyright © 2015 Institute of Psychoanalysis.
Full Text Available We present our findings in a case of primary neuroendocrine carcinoma (NEC of the lacrimal gland and a case of primary Merkel cell carcinoma (MCC of the eyelid. An 86-year-old man noticed a swelling of the left upper eyelid three months earlier. We performed excision biopsy and histopathological examination indicated that he had a primary NEC of the left lacrimal gland. He underwent chemotherapy followed by excision including the clinically visible margins and 50 Gy radiotherapy of the surgical margins. He had neither recurrence nor metastasis for 6 months since the last radiotherapy. An 80-year-old man noticed a nodule in the right upper eyelid and was referred to our hospital because the size was increasing rapidly. A complete surgical excision of the margins of the tumor was performed with histopathological confirmation of negative margins. The final diagnosis was a primary MCC of the right upper eyelid. After surgery, he underwent 50 Gy radiotherapy on the neck to prevent metastasis. No recurrence or metastasis was found for two years. Although primary NEC of the ocular adnexa is extremely rare, the tumor has high malignancy and readily metastasizes. Thus, combined therapy including surgery, radiotherapy, and/or chemotherapy is needed for complete management of NEC.
Full Text Available Human immunodeficiency virus infection is the first major pandemic of the 20th century. At present, almost 10 million people are known to be infected with this virus, and it is estimated that by the year 2000, approximately 40 million people will be infected. Transmission of this deadly infection is predominantly by sexual contact. Individuals infected with this virus pass through several predictable stages with progressive decrease in circulating CD4+ T cells. During the advanced stage, these patients develop various opportunistic infections or malignancies, or both. It is this advanced stage that was first recognized as AIDS, which has a 100% mortality rate. The opportunistic organisms that can involve the eye in patients with AIDS include cytomegalovirus, herpes zoster, Toxoplasma gondii, Mycobacterium tuberculosis, Cryptococcus neoformans, Mycobacterium avium-intracellulare, Pneumocystis carinii, Histoplasma capsulatum, Candida, and others. Intraocular lesions from these agents often represent disseminated infections. Visual morbidity occurs secondary to retinitis due to cytomegalovirus, herpes zoster, or Toxoplasma gondii. Anti-viral agents such as ganciclovir or foscarnet are effective against cytomegalovirus infection. The role of the ophthalmologist in the diagnosis and management of AIDS is becoming increasingly important. Not only does the eye reflect systemic disease, but ocular involvement may often precede systemic manifestations. In the AIDS patient, the ophthalmologist thus has an opportunity to make not only a slight-saving, but also life-saving diagnosis of disseminated opportunistic infections.
Ryle, James P.; Al-Kalbani, Mohammed; Collins, Niamh; Gopinathan, Unnikrishnan; Boyle, Gerard; Coakley, Davis; Sheridan, John T.
Ocular microtremor (OMT) is a biological high frequency (up to 150Hz) low amplitude (25-2500nm peak to peak) involuntary motion of the human eye. Clinical OMT investigations to date have used eye-contacting mechanical piezoelectric probes or piezoelectric strain gauges. Before contact can be made, the eye must first be anaesthetized. In some cases, this eyelid spasms occur making it impossible to measure OMT. Using the contact probe method, the eye motion is mechanically loaded. Results from clinical studies with this method to date have given electrical signal amplitudes from the probe proportional to the displacement, but not the exact displacement information. Recent studies suggest a number of clinical applications for OMT, these include monitoring the depth of anesthesia of a patient in surgery, prediction of outcome in coma, diagnosis of brain stem death. In addition to this, in patients with neurological disorders such as Multiple Sclerosis and Parkinson's disease, abnormal OMT frequency content is present. In this paper, we design a compact non-contact phase modulating optical fiber speckle interferometer to measure eye motions. We simulate OMT motion using a calibrated piezoelectric vibration simulator and compare results produced using a contact method with those using our optical non-contact method.
Full Text Available Parasites are a group of eukaryotic organisms that may be free-living or form a symbiotic or parasitic relationship with the hosts. Consisting of over 800,000 recognized species, parasites may be unicellular (Protozoa or multicellular (helminths and arthropods. The association of parasites with human population started long before the emergence of civilization. Parasitic zoonotic diseases are prevalent worldwide including India. Appropriate epidemiological data are lacking on existing zoonotic parasitic diseases, and newer diseases are emerging in our scenario. Systemic diseases such as cysticercosis, paragonimiasis, hydatidosis, and toxoplasmosis are fairly common. Acquired Toxoplasma infections are rising in immune-deficient individuals. Amongst the ocular parasitic diseases, various protozoas such as Cystoidea, trematodes, tissue flagellates, sporozoas etc. affect humans in general and eyes in particular, in different parts of the world. These zoonoses seem to be a real health related problem globally. Recent intensification of research throughout the world has led to specialization in biological fields, creating a conducive situation for researchers interested in this subject. The basics of parasitology lie in morphology, pathology, and with recent updates in molecular parasitology, the scope has extended further. The current review is to address the recent update in ophthalmic parasites with special reference to pathology and give a glimpse of further research in this field.
Das, Dipankar; Ramachandra, Varsha; Islam, Saidul; Bhattacharjee, Harsha; Biswas, Jyotirmay; Koul, Akanksha; Deka, Panna; Deka, Apurba
Parasites are a group of eukaryotic organisms that may be free-living or form a symbiotic or parasitic relationship with the hosts. Consisting of over 800,000 recognized species, parasites may be unicellular (Protozoa) or multicellular (helminths and arthropods). The association of parasites with human population started long before the emergence of civilization. Parasitic zoonotic diseases are prevalent worldwide including India. Appropriate epidemiological data are lacking on existing zoonotic parasitic diseases, and newer diseases are emerging in our scenario. Systemic diseases such as cysticercosis, paragonimiasis, hydatidosis, and toxoplasmosis are fairly common. Acquired Toxoplasma infections are rising in immune-deficient individuals. Amongst the ocular parasitic diseases, various protozoas such as Cystoidea, trematodes, tissue flagellates, sporozoas etc. affect humans in general and eyes in particular, in different parts of the world. These zoonoses seem to be a real health related problem globally. Recent intensification of research throughout the world has led to specialization in biological fields, creating a conducive situation for researchers interested in this subject. The basics of parasitology lie in morphology, pathology, and with recent updates in molecular parasitology, the scope has extended further. The current review is to address the recent update in ophthalmic parasites with special reference to pathology and give a glimpse of further research in this field.
The design and testing of an ocular Shack-Hartmann aberrometer is presented. The aberrometer objectively measures optical aberrations in the human eye in vivo. The sensor was successfully tested for measurements of refractive error (sphere and cylinder) and spherical aberration. Vignetting limits the measurement range of the wavefront to a range of -10 D to +15 D. Large refractive errors and decentration of the measurement induce aberrations in the test wavefront. Analytical tools to correct for these systematic errors were developed. A clinical study was conducted assessing visual performance in 158 eyes of 89 subjects before and after LARK refractive surgery. The main results of the study were that refractive surgery corrects refractive errors very accurately. A slight regression in refraction during the 12 months after surgery was noted. Measurements of ocular aberrations using the Shack-Hartmann aberrometer revealed that refractive surgery introduced large amounts of higher order aberrations, mainly spherical aberration and coma. The amount of aberrations changed significantly during the 12 months wound healing period. The dark adapted pupil diameter of the eye increased significantly during the first 6 months after surgery. The changes in ocular aberrations and pupil diameter were correlated to changes in contrast sensitivity in the human eye. The analysis of corneal topography showed that while the anterior corneal curvature changed due to surgery, we also saw a change in the posterior corneal curvature as a biomechanical response to surgery. A Customized Eye Model was designed and tested based on the clinical measurements. The model used conic surfaces and modeled defocus and spherical aberration. This computer eye model was then used in optical lens design software to calculate an optimal Customized Ablation Pattern for individual eyes.
The low intensity laser therapy (LILT) has been extensively used in medicine and dentistry presenting positive effects. However, the laser radiation can also cause adverse effects. Due to the ocular focalization property, in the wavelength from 400 to 1400 nm, the retina is more susceptible to damage by radiation than any other part of the human body. Then, the ocular protection is frequently emphasized. This protection must attenuate the radiation to a safe level. The International Electrotechnical Commission (IEC) standard IEC 60825-1 suggests safety requirements for medical laser equipment, including the ocular protection, based on maximum permissible exposure levels. The Brazilian legislation adopts a corresponding IEC standard, the NBR IEC 601.2.22, for safety requirements. The aim of this study was to analyze the adequacy of the ocular protectors furnished by four laser equipment manufacturers, commercially available in Brazil, commonly used for LILT. For this purpose, the laser equipment and the respective ocular protectors were characterized. The adequacy was verified according to the IEC standards. It was found, among other results, ocular protectors attenuating to safe levels the radiation emitted by the respective laser equipment, however, presenting inadequate visual transmission. Inefficient protection and protection indicated in cases where they were not necessary were also observed. (author)
Full Text Available AIM: To study the clinical profile of ocular injuries in children in a tertiary care center in Northern India.METHODS: This was a hospital based descriptive study. All children of ocular injuries up to 16y of age were included. Data regarding the socio-economic status, medical/surgical treatment, and condition at discharge were recorded. Follow-up to 3mo was done in the study. Initial and final visual acuity was recorded. Ocular Trauma Classification Group guidelines and Birmingham Eye Trauma Terminology were used for the definitions and classifications of ocular trauma. Socio-economic status grading is done according to modified B.G. Prasad classification and Kuppuswamy's socio-economic scale.RESULTS: Out of 42 children, male to female ratio was 3.6:1.Maximum number(50%of injuries occurred between 11-16y of age. Most of the children(59.52%belonged to lower socio-economic class and were from arural background. Ocular injuries occurred at home in 20(47.61%children followed by 6(14.28%each in school, playground, and street. Open globe injuries were seen in 19(45.24%children and 23(54.75%children had closed globe injuries. Injuries by wooden stick, stone, firework, fall, toy were 12(28.57%, 5(11.90%, 3(7.14%, 3(7.14%, and 2(4.76%. Seventeen(40.47%children required medical management and 25(59.53%were treated surgically.CONCLUSION:Male children in rural regions and of lower socio-economic background were more prone to ocular injuries. Children were more risk of ocular injuries at home. Wooden sticks and stone were the commonest cause of ocular injuries. Ocular morbidity and poor visual outcome were seen more in open globe injuries. Further population-based studies are required to reinforce findings of present study. Based on this, a long term strategy can be planned to prevent ocular injuries in children in this region.
Jorge Alberto Llerena Rodríguez
Full Text Available Se realizó una revisión de las principales tendencias en el manejo de los traumatismos oculares a globo abierto según la clasificación internacional de Birmingham. Se mencionan los elementos que pueden influir en el pronóstico visual. Se enfatiza en los criterios diagnósticos, cuadro clínico y terapéutica clínico-quirúrgica a instaurar por el médico en el servicio de urgencias. Se presenta un algoritmo al efecto.The main tendencies in the management of the ocular open-globe injuries, according to Birmingham’s international classification, were reviewed. Those aspects that might have an effect on the visual outcomes were stated. Emphasis was made on the diagnostic criteria, the clinical picture and the surgical and therapeutic treatments that a physician may resort to in the emergency room; for this purpose, an algorithm to manage this visual problem was submitted.
Full Text Available An important component of the World Health Organization's comprehensive trachoma elimination strategy is the provision of repeated annual mass azithromycin distributions, which are directed at reducing the burden of ocular chlamydia. Knowledge of characteristics associated with infection after mass antibiotic treatments could allow trachoma programs to focus resources to those most likely to be infected with ocular chlamydia.We monitored 12 communities in rural Ethiopia that had received 3 annual mass azithromycin treatments as part of a cluster-randomized trial for trachoma. One year after the third treatment, a random sample of children from each village received conjunctival examination for follicular trachomatous inflammation (TF and intense trachomatous inflammation (TI, conjunctival swabbing for chlamydial RNA and DNA, and a household survey. The primary outcome for this study was RNA evidence of ocular chlamydia, which we detected in 41 of 573 swabbed children (7.2%, 95%CI 2.7-17.8. In multivariate mixed effects logistic regression models, ocular chlamydial RNA was significantly associated with ocular discharge (OR 2.82, 95%CI 1.07-7.42, missing the most recent mass azithromycin treatment (OR 2.49, 95%CI 1.02-6.05, having a sibling with ocular chlamydia (OR 4.44, 95%CI 1.60-12.29, and above-median community population (OR 7.81, 95%CI 1.56-39.09. Ocular chlamydial infection was also independently associated with TF (OR 3.42, 95%CI 1.56-7.49 and TI (OR 5.39, 95%CI 2.43-11.98.In areas with highly prevalent trachoma treated with multiple rounds of mass azithromycin, trachoma programs could consider continuing mass azithromycin treatments in households that have missed prior mass antibiotic treatments, in households with clinically active trachoma, and in larger communities.
Full Text Available Aims: The aim of this study was to assess ocular changes in thalassemia patients who have received multiple transfusions and chelate binding therapy in order to avoid iron accumulation. Settings and Design: A cross-sectional study. Subjects and Methods: A total of 54 thalassemia major patients were selected as case group, and 54 age- and sex-matched healthy subjects were regarded as a control group. Ocular examination included visual acuity, refraction testing, slit lamp examination, funduscopy, tonometry, perimetry, tear break-up time test, and color vision testing were performed for all the participants. We computed the frequency and duration of blood transfusion, the mean serum ferritin level, pretransfusion hemoglobin concentration, and type, duration, and daily dose of chelation therapy for thalassemia patients based on their records. Statistical Analysis Used: All data analysis was performed using SPSS, version 19. Results: All the thalassemic patients were asymptomatic, but abnormal ocular findings (dry eye (33.3%, cataract (10.2%, retinal pigment epithelium degeneration (16.7%, color vision deficiency (3.7%, and visual field defects (33.7% were seen in 68.5% of thalassemic group. The prevalence of ocular abnormalities in normal group was 19.4%, which was significantly lower than that in thalassemia patients (P = 0.000. No significant correlation was found between ocular abnormalities and mean serum ferritin level (P = 0.627 and mean hemoglobin concentration (P = 0.143. Correlation of number of blood transfusion with the presence of ocular abnormalities was found to be statistically significant (P = 0.005. Conclusions: As life expectancy for beta-thalassemia patients extends, regular ophthalmological evaluation to detect early changes in their ocular system is recommended.
Raúl Rúa Martínez
Full Text Available El osteoma coroideo es un tumor benigno, óseo y fue descrito por primera vez en 1978 por Gass y otros. Generalmente es unilateral, de localización juxtapapilar y más frecuente en mujeres adultas jóvenes. Presenta una etiología desconocida pero se asocian diferentes factores como: procesos inflamatorios, malformaciones congénitas, alteraciones hormonales y traumas oculares entre otros. Se presenta una paciente del sexo femenino, de 54 años de edad, con antecedentes patológicos personales de fibromialgia reumática (osteoartritis y osteoporosis e hipertensión arterial. En los antecedentes oftalmológicos presentaba miopía leve y retinopatía arteriolosclerótica. La paciente refiere que sufrió un accidente de tránsito y recibió lesiones contusas en miembros y región periocular. A partir de ese momento comenzó con mala visión del ojo derecho y acude a nuestro servicio seis meses después. Se le realizó examen oftalmológico y los datos positivos en el ojo derecho fueron una agudeza visual de 0,4, con corrección alcanzaba 1,0 y al fondo de ojo se detecta estreches vascular, desprendimiento de vítreo posterior incompleto y una lesión blanquecina naranja de tres diámetros papilares en polo posterior que involucraba arcada temporal inferior con borde bien definidos. Se realizó angiografía que mostró hiperfluorescencia mantenida y no neovascularización; la tomografía de coherencia óptica reveló un halo de desprendimiento de retina seroso a su alrededor. El ultrasonido destaca una imagen ecogénica de alta reflexividad que involucra coroides con silencio acústico posterior. El osteoma constituye una patología no muy frecuente, cuyo diagnóstico es imagenológico, y se destaca el hecho de ser secundario a un trauma ocular.The choroidal osteoma is a benign bony tumor described for the first time in 1978 by Gass and collaborators. It is generally unilateral, with juxtapapillary localization and more frequent in young adult
Petersen, Kjell Yngve; Søndergaard, Karin; Kongshaug, Jesper
differently into an architectural body. We also examine what might occur when light is dynamic and able to change colour, intensity and direction, and when it is adaptive and can be brought into interaction with its surroundings. In short, what happens to an architectural space when artificial lighting ceases......Adaptive Lighting Adaptive lighting is based on a partial automation of the possibilities to adjust the colour tone and brightness levels of light in order to adapt to people’s needs and desires. IT support is key to the technical developments that afford adaptive control systems. The possibilities...... offered by adaptive lighting control are created by the ways that the system components, the network and data flow can be coordinated through software so that the dynamic variations are controlled in ways that meaningfully adapt according to people’s situations and design intentions. This book discusses...
Mohammed, Imran; Said, Dalia G; Dua, Harminder S
Sight depends on the passage of light through the transparent cornea and being focused on the fovea. Its exposed position renders it vulnerable to microbial infection. The cornea has developed a wide array of defense mechanisms against infection, of which endogenous antimicrobial peptides (AMPs) are key. AMPs are essentially small molecular weight cationic peptides with a wide range of activity against virus, bacteria, fungi and parasites. Some proteins such as RNases and S100As are also included in this group. Several AMPs act synergistically allowing low expression of multiple AMPs to act efficiently. AMPs also have a range of non-microbicidal functions and serve as signaling molecules, immunomodulators; show anti-tumour activity, and influence vascularization and wound healing. Different toll-like receptors (TLR) have been implicated in the preferential induction of specific AMPs. A range of bacteria, including mycobacteria tuberculosis, viruses including herpes virus, fungi and parasites including acanthamoeba, that cause ocular infections have been shown to induce specific AMPs via TLR activation. Non-TLR mediated induction of AMP expression can occur and several molecules such as L-isoleucine, sodium butyrate, vitamin D3, phenylbutyrate, vasoactive intestinal peptide, and etinostat have been identified in this regard. Given the rising microbe resistance to antibiotics, the slow rate of development of new antibiotics and the limited access to effective antibiotics by patients living in the developing world, an ideal solution would be to find AMPs that are effective singly or in combination with each other or other antimicrobial proteins to reduce, if possible eliminate reliance on antibiotics alone. Copyright © 2017 Elsevier Ltd. All rights reserved.
Full Text Available Life expectancy at birth has regularly increased decade after decade, especially since the beginning of the 20th century: 15 years have been gained over the past 50 years. Changes in living and dietary habits during this time period have been associated with the development of various pathologies which represent a growing socioeconomic burden. Among age-related disorders, ocular diseases are the second most prevalent ones after 65 years. Age-related Macular Degeneration (AMD is the leading cause of visual impairment after the age of 50 years. Age is the prominent risk factor for AMD and is accompanied with both endogenous (including genetics and environmental factors, such as smoking habits and dietary factors (diet rich in cholesterol and saturated fatty acids. AMD is characterized by the loss of cells at the most central area of the retina, called macula. The neural retina is a highly structured neurosensory tissue that is responsible for the transduction pathway. The transduction pathway is initiated in photoreceptors where the light stimulus is coded into an electrical signal. This signal is transmitted to neighboured neurons and transferred to the brain via the optic nerve. The retinal pigment epithelium (RPE is the cellular and metabolic interface between the neural retina and choriocapillaris through Bruch’s membrane. The close association between RPE and photoreceptors is one of the factors that promote the efficacy of RPE to, in the one hand, provide nutrients and oxygen to photoreceptors and, in the other hand, eliminate the metabolic debris originating from shedding of the outer segments. Epidemiological data suggest that dietary habits privileging the consumption of omega- 3 long chain polyunsaturated fatty acids participate to prevent from the development of AMD (Sangiovanni et al., 2009. The mechanisms underlying the effects of omega-3 fatty acids remain unclear until now. The purpose of the present paper is to give a review on
Ullah, Tehseena; Gurwood, Andrew S; Myers, Marc D
Metastatic melanoma to the eye and orbit are rare. Patients at greatest risk often have disseminated metastases in the setting of advanced disease. Because the prognosis for orbital metastatic disease is poor, emphasis must be placed on early detection and prevention. Although cutaneous malignancies include basal cell carcinoma, squamous cell carcinoma, sebaceous cell carcinoma, and malignant melanoma, the majority of cases that result in metastasis, ocular morbidity, and mortality are from sebaceous cell carcinoma and malignant melanoma. A 72-year-old white woman presented emergently with a chief complaint of sudden, painless vision loss in her left eye of 2 weeks' duration. Her best-corrected visual acuities measured 20/30 in the right eye and 20/400 in the left eye with no improvement on refraction. Her systemic medical history was significant for the diagnosis of a cutaneous malignant melanoma. Examination of the left eye found grade II disc edema with all other posterior pole and peripheral structures intact and unremarkable. Magnetic resonance imaging confirmed the diagnosis of metastatic lesions involving structures of the left orbit ultimately causing reduced visual ability. The patient opted to avoid aggressive care and "hope for the best." Denying significant medical intervention, the woman lived in hospice where she died 6 months later. The primary care optometric setting, by the way a patient's visual symptoms present or the appearance of fundus abnormalities, can offer the capability of first detection and referral for the discovery of metastatic lesions. Although orbital metastasis is considered a terminal finding in these cases, timely diagnosis enables, while limited, the best options for management.
Mäntyjärvi, M; Tuppurainen, K
Fifty-six ocular hypertension (OHT) patients were examined for 2-3 days in the Eye Clinic of Kuopio University Hospital. No glaucomatous changes were found. Twenty-seven of them were found to have several risk factors for developing glaucoma and medication was started. Twenty-nine of the patients did not show risk factors and had no medication. Color vision was examined with the Farnsworth-Munsell 100 (FM 100) hue test and Besançon anomalometer, later Color Vision Meter 712 at the beginning of the study and 3 years later. None of the 56 patients showed any glaucomatous changes after 3 years of the study. In the treatment group, the FM 100 test showed significantly (paired t-test, p = 0.004) improved error scores after 3 years. In the non-treatment group, 19 patients did not develop risk factors; they had no significant changes in the color vision results. In 10 patients of the non-treatment group, risk factors had developed with elevated intraocular pressure and medication was started for them after 3 years. Their color vision results in the blue anomalous quotient (AQ) of the anomalometer had significantly shifted to the blue part of the equation (paired t-test, p = 0.04). The other color vision results had not changed significantly. The significantly improved FM 100 scores in the treatment group could mean, that the treatment has a beneficial effect for the OHT eyes at risk for developing glaucoma.(ABSTRACT TRUNCATED AT 250 WORDS)
Nyo Nyo Min
Full Text Available AIM:To describe the epidemiology of work-related ocular injuries and its visual outcome in tertiary hospital in southern Malaysia. METHODS:Retrospective review of medical records of patients diagnosed as work-related ocular injuries who attended to the eye casualty of Hospital Sultan Ismail in Johor Bahru, Malaysia from Jan. 2011 to Dec. 2013. Data for clinical presentation, types of injuries, use of eye protective device(EPDand visual outcome were collected using a standardized proforma.RESULTS: A total of 935 ocular injuries attended to Hospital Sultan Ismail during 3y period. Among them 440 cases were work-related ocular injuries and included in the study. There was significant male preponderance(98.19%and commonest age group affected was 21 to 30y(45%. The most common type of injury was superficial injuries(70.91%, followed by chemical(11.13%, open globe(8.41%, closed globe(6.83%and thermal(2.72%. Although Malays are commonly involved in work-related ocular injury accounted for 78.47%, two-thirds of open globe injuries were seen in foreign workers. Only 59 patients(13.41%reported that they wore EPD at the time of incident. Generally, 89.86%(n=399had good vision, 5.45%(n=24had moderate vision and 3.86%(n=17poor vision. Visual outcome related to specific types of injuries showed that poor outcome was higher in open globe injuries groups compared with closed globe injuries \\〖odd ratio(OR=3.33, 95% confidence interval(CI=0.68 to 16.33\\〗. Overall hospital attendance rate of work-related ocular trauma ranged from 20.7 to 51.9 per 1000 new cases and decline of approximately 1.5% per year(PCONCLUSION: Work-related ocular trauma is important cause of ocular morbidity in working forces particularly young men. Malay males between 21 to 40y have higher risk. Majority of work-related ocular trauma seen in our hospital are generally of superficial injuries and potentially preventable. This study indicates they need to improve safety measures to
Ana Paula Hvenegaard
Full Text Available A retrospective study was conducted to identify the occurrence and types of ocular disorders in 57 Amazon parrots admitted to the Ophthalmology Service, Veterinary Teaching Hospital, School of Veterinary Medicine, University of São Paulo, Brazil from 1997 to 2006. The most frequent observed disorder was cataracts, present in 24 of the 114 examined eyes (57 parrots. Uveitis, ulcerative keratitis and keratoconjunctivitis were frequently diagnosed as well. The cornea was the most affected ocular structure, with 28 reported disorders. Uveal disorders also were commonly observed. Conjunctiva and eyelid disorders were diagnosed in lower frequency. Results suggest that cataracts are common and that cornea, lens and uvea are the most affected ocular structures in Amazon parrots.Realizou-se estudo retrospectivo para identificar a ocorrência e os tipos de alterações oculares observadas em 57 papagaios atendidos no Serviço de Oftalmologia do Hospital Veterinário da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo (USP, de 1997-2006. Catarata em diferentes estágios de evolução foi a alteração ocular mais frequentemente diagnosticada, sendo observada em 24 dos 114 olhos examinados. Uveíte, ceratite ulcerativa e ceratoconjuntivite foram também diagnosticadas. A córnea foi a estrutura ocular mais acometida (28 registros. Alterações uveais foram frequentemente observadas. Alterações das pálpebras e conjuntiva foram observadas em menor freqüência. Concluí-se que catarata foi a alteração mais frequentemente observada e que a córnea, lente e úvea são as estruturas oculares mais susceptíveis a alterações em papagaios.
Full Text Available Introdução: Para se verificar a prevalência de anomalias oculares em indivíduos portadores de deficiência auditiva de causa genética definitiva ou suspeita, este trabalho apresenta a avaliação oftalmológica de 97 indivíduos portadores de deficiência auditiva. Pacientes e Métodos: 97 indivíduos com diagnóstico definitivo ou suspeito de causa genética para disacusia foram submetidos a exame clínico oftalmológico completo; destes, 10 foram excluídos. Resultados: 42 (48,28% dos pacientes apresentaram uma ou mais anomalias oculares, 22 (25,29% pacientes apresentaram várias anormalidades oculares e quadro clínico compatíveis com síndromes genéticas estabelecidas. Conclusões: O exame oftalmológico é importante no diagnóstico sindrômico e etiológico de alguns quadros de disacusia, pois as alterações oculares podem ser a única anomalia associada à mesma.Purpose: In order to verify the prevalence of ocular abnormalities in patients who are deaf due to genetic causes, this paper presents the visual assessment of 97 deaf patients. Methods: 97 patients with definite or suspected diagno- sis of congenital and genetic deafness underwent a complete ophthalmologic evaluation; 10 patients were excluded. Results: 42 (48.28% patients presented one or more ocular abnormalities, 22 (25.29% patients presented several abnormalities and clinical manifestations of established genetic diseases. Conclusions: The ocular abnormalities may be the only clinical manifestations associated with deafness. Therefore the ophthalmological examination is a helpful tool for the etiological diagnosis of deafness.
Barry M Seemungal
Full Text Available Unpleasant visual symptoms including oscillopsia and dizziness may occur when there is unexpected motion of the visual world across the subject’s retina (‘retinal-slip’ as in an acute spontaneous nystagmus or on head movement with an acute ophthalmoplegia. In contrast, subjects with chronic ocular dysmotility, e.g. congenital nystagmus or CPEO (chronic progressive external ophthalmoplegia, are typically symptom free. The adaptive processes that render chronic patients asymptomatic are obscure but may include a suppression of oscillopsia perception as well as an increased tolerance to perceived oscillopsia. Such chronic asymptomatic patients display an attenuation of vestibular-mediated angular velocity perception, implying a possible contributory role in the adaptive process. In order to assess causality between symptoms, signs (i.e. eye-movements and vestibular perceptual function, we prospectively assessed symptom ratings and ocular-motor and perceptual vestibular function, in a patient with acute but transient ophthalmoplegia due to Miller Fisher Syndrome (as a model of visuo-vestibular adaptation. The data show that perceptual measures of vestibular function display a significant attenuation as compared to ocularmotor measures during the acute, symptomatic period. Perhaps significantly, both symptomatic recovery and normalisation of vestibular perceptual function were delayed and then occurred in a parallel fashion. This is the first report showing that symptomatic recovery of visuo-vestibular symptoms is better paralleled by vestibular-perceptual testing than VOR (vestibular ocular reflex measures. The findings may have implications for the understanding of patients with chronic vestibular symptoms where VOR testing is often unhelpful.
Bartra, J; Mullol, J; Montoro, J; Jáuregui, I; del Cuvillos, A; Dávila, I; Ferrer, M; Sastre, J; Valero, A
Ocular symptoms often accompany allergic rhinitis and can be as or even more bothersome for the patient than the actual nasal symptoms. Ocular manifestations of allergic rhinoconjunctivitis may result from both direct allergen-mediated mast cell stimulation on the surface of the eye and naso-ocular reflexes--histamine being one of the mediators of symptoms onset. An H1 antihistamine would be the first line treatment for allergic conjunctivitis. Since allergic conjunctivitis is always (or almost always) accompanied by nasal symptoms, a second-generation H1 antihistamine administered via oral route is the drug of choice for jointly managing both the nasal and the ocular symptoms--minimizing the impact of the effects inherent to first-generation H, antihistamine, including particularly drowsiness. Bilastine is a new H1 antihistamine with an excellent safety profile, developed for the treatment of allergic rhinoconjunctivitis and urticaria, with potency similar to that of cetirizine and desloratadine, and superior to that of fexofenadine. This new drug has been shown to be effective in controlling the ocular symptoms of allergic rhinoconjunctivitis.
Chai Lee Tan
Full Text Available Background. Ocular bartonellosis can present in various ways, with variable visual outcome. There is limited data on ocular bartonellosis in Malaysia. Objective. We aim to describe the clinical presentation and visual outcome of ocular bartonellosis in Malaysia. Materials and Methods. This was a retrospective review of patients treated for ocular bartonellosis in two ophthalmology centers in Malaysia between January 2013 and December 2015. The diagnosis was based on clinical features, supported by a positive Bartonella spp. serology. Results. Of the 19 patients in our series, females were predominant (63.2%. The mean age was 29.3 years. The majority (63.2% had unilateral involvement. Five patients (26.3% had a history of contact with cats. Neuroretinitis was the most common presentation (62.5%. Azithromycin was the antibiotic of choice (42.1%. Concurrent systemic corticosteroids were used in approximately 60% of cases. The presenting visual acuity was worse than 6/18 in approximately 60% of eyes; on final review, 76.9% of eyes had a visual acuity better than 6/18. Conclusion. Ocular bartonellosis tends to present with neuroretinitis. Azithromycin is a viable option for treatment. Systemic corticosteroids may be considered in those with poor visual acuity on presentation.
Cabalag, Miguel S; Wasiak, Jason; Syed, Quaderi; Paul, Eldho; Hall, Anthony J; Cleland, Heather
The surgical management of severe ocular burns is challenging and often associated with variable long-term outcome. The aims of this study were to analyze the clinical course of these injuries and determine the factors associated with the need for surgery. A retrospective medical records review was conducted for patients admitted to the Victorian Adult Burns Services, with ocular burns, from January 2000 to January 2010. One hundred and twenty-nine patients were admitted with ocular burns, of which 17 (13.2%) required surgery. The most common indication for surgery was ectropion (n = 9) and the most frequent procedure was full-thickness skin grafts to the eyelids (n = 10). Almost all patients managed surgically developed late ocular complications, the most frequent being visual loss and recurrent ectropion (n = 7 each). Patients undergoing surgery had a longer length of hospital stay (median [interquartile range] 40 [12-90] vs 12 [4-29.5] days; P = .004) and larger TBSA burned (median [interquartile range] 20 [10-60] vs 8 [4-20]; P = .011). Factors associated with the need for surgery included flame burns, periorbital edema, visual loss on presentation, increasing severity of eyelid and facial burns, severe corneal injury, as well as lagophthalmos, ectropion, and microbial keratitis (P ocular morbidity.
Patel, Ravija; Mukherjee, Bipasha
To identify the patterns of ocular injury and to determine ocular morbidity resulting from the use of firecrackers. A prospective observational study of all patients presenting with ocular trauma consequent to fireworks usage in a tertiary eye care center in South India over a one-month period around the autumn festival of Diwali. We also reviewed the published literature from around the world reporting ocular injuries due to firecrackers. 49 patients were included in the study, out of which the vast majority (40/81%) were males. The mean age was 17 years. Almost an equal number of bystanders (24/48.9%) was affected as compared to people handling the fireworks (25/51%). 13 (26.53%) patients had open-globe injury whereas 33 (67.34%) patients had closed-globe injury. Twenty-two (44.8%) patients underwent surgical intervention. Eighteen (36.7%) patients had final vision less then 20/40 (range = 20/50 to No Perception of Light) with eight patients having no perception of light in the affected eye. Unregulated use of firecrackers can lead to significant ocular morbidity, mainly involving children, young males, and even innocent bystanders. A combination of public awareness and appropriate legislative laws should be formulated regarding the use of fireworks to decrease the load of needless blindness on society.
Kim, Joo Hyun; Kim, Jung Ha; Nam, Woo Ho; Yi, Kayoung; Choi, Dong Gyu; Hyon, Joon Young; Wee, Won Ryang; Shin, Young Joo
To investigate whether ethanol administration disturbs the tear film and ocular surface. Case-control study. Twenty healthy male subjects were recruited. Ethanol was administered to 10 subjects and another 10 subjects served as controls. Twenty healthy male subjects with no ocular disease were recruited. Ethanol (0.75 g/kg) was administered orally at 8 pm for 2 hours to 10 subjects. The tear film and ocular surface were evaluated at 6 pm before drinking, at midnight, and immediately (6 am) and 2 hours (8 am) after waking the next morning. Tear osmolarity, ethanol concentration in tears and serum, Schirmer's test results, tear film break-up time (TBUT), corneal punctuate erosion, and corneal sensitivity were measured. Ethanol was detected in tears and serum at midnight, but it was not detected the next morning. The mean tear osmolarity level increased in the alcohol group at midnight compared with that in the control group (Ptears. Ethanol in tears induced tear hyperosmolarity and shortened TBUT and triggered the development of ocular surface diseases. Similar changes could exacerbate signs and symptoms in patients with ocular surface disease. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
Sodi, Andrea; Giacomelli, Giovanni; Corvi, Andrea; Menchini, Ugo
Background. The aim of this study is to investigate the ocular thermographic profiles in age-related macular degeneration (AMD) eyes and age-matched controls to detect possible hemodynamic abnormalities, which could be involved in the pathogenesis of the disease. Methods. 32 eyes with early AMD, 37 eyes with atrophic AMD, 30 eyes affected by untreated neovascular AMD, and 43 eyes with fibrotic AMD were included. The control group consisted of 44 healthy eyes. Exclusion criteria were represented by any other ocular diseases other than AMD, tear film abnormalities, systemic cardiovascular abnormalities, diabetes mellitus, and a body temperature higher than 37.5°C. A total of 186 eyes without pupil dilation were investigated by infrared thermography (FLIR A320). The ocular surface temperature (OST) of three ocular points was calculated by means of an image processing technique from the infrared images. Two-sample t-test and one-way analysis of variance (ANOVA) test were used for statistical analyses. Results. ANOVA analyses showed no significant differences among AMD groups (P value >0.272). OST in AMD patients was significantly lower than in controls (P > 0.05). Conclusions. Considering the possible relationship between ocular blood flow and OST, these findings might support the central role of ischemia in the pathogenesis of AMD. PMID:25436140
Ziebarth, Noël M.; Rico, Felix; Moy, Vincent T.
In recent years, the atomic force microscope (AFM) has become an important tool in ophthalmic research. It has gained popularity largely because AFM is not restricted by the diffraction limits of light microscopy and can be applied to resolve images with molecular resolution. AFM is a minimally invasive technique and can be used to visualize molecular structures under near-physiological conditions. In addition, the AFM can be employed as a force apparatus to characterize the viscoelastic properties of biomaterials on the micron level and at the level of individual proteins. In this article, we summarize recent AFM studies of ocular tissues, while highlighting the great potential of AFM technology in ophthalmic research. Previous research demonstrates the versatility of the AFM as high resolution imaging technique and as a sensitive force apparatus for probing the mechanical properties of ocular tissues. The structural and mechanical properties of ocular tissues are of major importance to the understanding of the optomechanical functions of the human eye. In addition, AFM has played an important role in the development and characterization of ocular biomaterials, such as contact lenses and intraocular lenses. Studying ocular tissues using Atomic Force Microscopy has enabled several advances in ophthalmic research.
Butler, Nicholas J; Furtado, João M; Winthrop, Kevin L; Smith, Justine R
The term, ocular toxoplasmosis, refers to eye disease related to infection with the parasite, Toxoplasma gondii. Recurrent posterior uveitis is the typical form of this disease, characterized by unilateral, necrotizing retinitis with secondary choroiditis, occurring adjacent to a pigmented retinochoroidal scar and associated with retinal vasculitis and vitritis. Multiple atypical presentations are also described, and severe inflammation is observed in immunocompromised patients. Histopathological correlations demonstrate focal coagulative retinal necrosis, and early in the course of the disease, this inflammation is based in the inner retina. For typical ocular toxoplasmosis, a diagnosis is easily made on clinical examination. In atypical cases, ocular fluid testing to detect parasite DNA by polymerase chain reaction or to determine intraocular production of specific antibody may be extremely helpful for establishing aetiology. Given the high seroprevalence of toxoplasmosis in most communities, serological testing for T. gondii antibodies is generally not useful. Despite a lack of published evidence for effectiveness of current therapies, most ophthalmologists elect to treat patients with ocular toxoplasmosis that reduces or threatens to impact vision. Classic therapy consists of oral pyrimethamine and sulfadiazine, plus systemic corticosteroid. Substantial toxicity of this drug combination has spurred interest in alternative antimicrobials, as well as local forms of drug delivery. At this time, however, no therapeutic approach is curative of ocular toxoplasmosis. PMID:22712598
Full Text Available Ocular diseases, such as, glaucoma, age-related macular degeneration (AMD, diabetic retinopathy, and retinitis pigmentosa require drug management in order to prevent blindness and affecting million of adults in USA and worldwide. There is an increasing need to develop devices for drug delivery to address ocular diseases. This study focuses on the design, simulation, and development of an implantable ocular drug delivery device consisting of micro-/nanochannels embedded between top and bottom covers with a drug reservoir made from polydimethylsiloxane (PDMS which is silicon-based organic and biodegradable polymer. Several simulations were carried out with six different micro-channel configurations in order to see the feasibility for ocular drug delivery applications. Based on the results obtained, channel design of osmotic I and osmotic II satisfied the diffusion rates required for ocular drug delivery. Finally, a prototype illustrating the three components of the drug delivery design is presented. In the future, the device will be tested for its functionality and diffusion characteristics.
Louprasong, Amber C; Light, Dennis J; Diller, Rebecca S
Myotonic dystrophy is the most common adult-onset muscular dystrophy. It is an autosomal dominant inherited neuromuscular disease that is characterized by myotonia, muscle weakness, and atrophy. It affects multiple systems including skeletal muscular, gastrointestinal, cardiac, respiratory, central nervous, endocrine, and ocular. Ocular manifestations of myotonic dystrophy include cataract, ocular muscle changes, hypotony, and retinal pigmentary changes in the periphery or in the macula (known as pigment pattern dystrophy). This report presents and discusses the case of a pigmented pattern dystrophy known as spider dystrophy as an ocular manifestation of myotonic dystrophy. A 44-year-old man with myotonic dystrophy presented to the eye clinic for routine examination. Ocular history included previous bilateral cataract surgery and mild bilateral ptosis for the last "few years." Dilated fundus examination was remarkable for bilateral macular pigmentary changes in an irregular "spider"-shaped pattern. The patient was asymptomatic without decrease in vision or Amsler grid defects. Optical coherence tomography was normal. A retinal consult concurred with the diagnosis of spider dystrophy. Photo documentation was obtained, and the patient is being monitored annually. Pigmented pattern dystrophies, including spider dystrophy, have been associated with myotonic dystrophy. They are set apart from other retinal dystrophies because they rarely affect visual acuity, and the majority of patients are asymptomatic. Progression may lead to reduced vision and in rare cases choroidal neovascularization. Annual dilated examinations, photo documentation, optical coherence tomography, and home Amsler grid monitoring are recommended for follow-up care. Published by Elsevier Inc.
Siedlecki, Damian; Kowalik, Waldemar; Kasprzak, Henryk
The aim of the study is to demonstrate that the ocular dynamics of the anterior chamber of the eye can be estimated quantitatively by means of optical coherence tomography (OCT). A commercial high speed, high resolution optical coherence tomographer was used. The sequences of tomographic images of the iridocorneal angle of three subjects were captured and each image from the sequence was processed in MATLAB environment in order to detect and identify the contours of the cornea and iris. The data on pulsatile displacements of the cornea and iris and the changes of the depth of the gap between them were retrieved from the sequences. Finally, the spectral analysis of the changes of these parameters was performed. The results of the temporal and spectral analysis manifest the ocular microfluctuation that might be associated with breathing (manifested by 0.25 Hz peak in the power spectra), heart rate (1-1.5 Hz peak), and ocular hemodynamics (3.75-4.5 Hz peak). This paper shows that the optical coherence tomography can be used as a tool for noninvasive estimation of the ocular dynamics of the anterior segment of the eye, but its usability in diagnostics of the ocular hemodynamics needs further investigations.
Full Text Available Purpose. The aim of the study is to demonstrate that the ocular dynamics of the anterior chamber of the eye can be estimated quantitatively by means of optical coherence tomography (OCT. Methods. A commercial high speed, high resolution optical coherence tomographer was used. The sequences of tomographic images of the iridocorneal angle of three subjects were captured and each image from the sequence was processed in MATLAB environment in order to detect and identify the contours of the cornea and iris. The data on pulsatile displacements of the cornea and iris and the changes of the depth of the gap between them were retrieved from the sequences. Finally, the spectral analysis of the changes of these parameters was performed. Results. The results of the temporal and spectral analysis manifest the ocular microfluctuation that might be associated with breathing (manifested by 0.25 Hz peak in the power spectra, heart rate (1–1.5 Hz peak, and ocular hemodynamics (3.75–4.5 Hz peak. Conclusions. This paper shows that the optical coherence tomography can be used as a tool for noninvasive estimation of the ocular dynamics of the anterior segment of the eye, but its usability in diagnostics of the ocular hemodynamics needs further investigations.
Full Text Available Proper availability of drug on to corneal surface is a challenging task. However, due to ocular physiological barriers, conventional eye drops display poor ocular bioavailability of drugs (< 1%. To improve precorneal residence time and ocular penetration, earlier our group developed and evaluated in situ gel and nanoparticles for ocular delivery. In interest to evaluate the combined effect of in situ gel and nanoparticles on ocular retention, we combined them. We are the first to term this combination as "nanoparticle laden in situ gel", that is, poly lactic co glycolic acid nanoparticle incorporated in chitosan in situ gel for sparfloxacin ophthalmic delivery. The formulation was tested for various physicochemical properties. It showed gelation pH near pH 7.2. The observation of acquired gamma camera images showed good retention over the entire precorneal area for sparfloxacin nanoparticle laden in situ gel (SNG as compared to marketed formulation. SNG formulation cleared at a very slow rate and remained at corneal surface for longer duration as no radioactivity was observed in systemic circulation. The developed formulation was found to be better in combination and can go up to the clinical evaluation and application.
Full Text Available Background. The aim of this study is to investigate the ocular thermographic profiles in age-related macular degeneration (AMD eyes and age-matched controls to detect possible hemodynamic abnormalities, which could be involved in the pathogenesis of the disease. Methods. 32 eyes with early AMD, 37 eyes with atrophic AMD, 30 eyes affected by untreated neovascular AMD, and 43 eyes with fibrotic AMD were included. The control group consisted of 44 healthy eyes. Exclusion criteria were represented by any other ocular diseases other than AMD, tear film abnormalities, systemic cardiovascular abnormalities, diabetes mellitus, and a body temperature higher than 37.5°C. A total of 186 eyes without pupil dilation were investigated by infrared thermography (FLIR A320. The ocular surface temperature (OST of three ocular points was calculated by means of an image processing technique from the infrared images. Two-sample t-test and one-way analysis of variance (ANOVA test were used for statistical analyses. Results. ANOVA analyses showed no significant differences among AMD groups (P value >0.272. OST in AMD patients was significantly lower than in controls (P>0.05. Conclusions. Considering the possible relationship between ocular blood flow and OST, these findings might support the central role of ischemia in the pathogenesis of AMD.
Brand, Cristin; Zitzmann, Michael; Eter, Nicole; Kliesch, Sabine; Wistuba, Joachim; Alnawaiseh, Maged; Heiduschka, Peter
Klinefelter Syndrome (KS), the most common chromosomal disorder in men (47,XXY), is associated with numerous comorbidities. Based on a number of isolated case reports, we performed the first systematic and comprehensive evaluation of eye health in KS patients with a focus on ocular structure and vascularization. Twenty-one KS patients and 26 male and 38 female controls underwent a variety of non-invasive examinations investigating ocular morphology (examination of retinal thickness, optic nerve head, and cornea) and function (visual field testing and quantification of ocular vessel density by optical coherence tomography angiography). In comparison to healthy controls, KS patients exhibited a smaller foveal avascular zone and a decreased retinal thickness due to a drastically thinner outer nuclear layer. The cornea of KS patients showed a decreased peripheral thickness and volume. In perimetry evaluation, KS patients required brighter stimuli and gave more irregular values. KS patients show an ocular phenotype including morphological and functional features, which is very likely caused by the supernumerary X chromosome. Thus, KS should not be limited to infertility, endocrine dysfunction, neurocognitive and psychosocial comorbidities. Defining an aberrant ocular morphology and function, awareness for possible eye problems should be raised.
Seyyed Amir Hossein Ghazizadeh Hashemi
Full Text Available Introduction: Patients with bilateral weakness (BW have many difficulties in gaze stability that interfere with their normal function. The aim of this study was to evaluate ocular motor functions in patients with BW to better understand the problem of gaze instability in these patients. Materials and Methods: Patients were referred from the Otolaryngology Department for Vestibular Assessment to our clinic between November 2014 and March 2015. We assessed ocular motor function (gaze, saccade, and smooth pursuit in patients over the age of 18 years with BW, as verified by a caloric test. Results: Seventy-eight patients completed all the tests. The mean age of patients was 51.9 (±15.9 years, and 47 (60% were female. Abnormal results were found in five (6.4%, 32 (41%, and seven (9% patients with respect to gaze, smooth pursuit, and saccade, respectively. There were positive but relatively weak relationships between age and ocular motor results. Conclusion: Patients with BW suffer from dizziness and unsteadiness. These patients have abnormal function in ocular motor (especially smooth pursuit tests. The ocular motor dysfunction is responsible for gaze instability in static positions such as standing.
André Augusto Miranda Torricelli
Full Text Available It is widely recognized today that outdoor air pollution can affect human health. Various chemical components that are present in ambient pollution may have an irritant effect on the mucous membranes of the body, particularly those of the respiratory tract. Much less attention has been focused on the adverse effect on the ocular surface, despite the fact that this structure is even more exposed to air pollution than the respiratory mucosa since only a very thin tear film separates the corneal and conjunctival epithelia from the air pollutants. So far, clinical data are the more widespread tools used by ophthalmologists for assessing possible aggression to the ocular surface; however, clinical findings alone appears not to correlate properly with the complaints presented by the patients pointing out the need for further clinical and laboratory studies on the subject. The purpose of this study is to review signs and symptoms associated with chronic long-term exposure to environmental air pollutants on the ocular structures currently defined as the ocular surface and to review clinical and laboratory tests used to investigate the adverse effects of air pollutants on such structures. We also review previous studies that investigated the adverse effects of air pollution on the ocular surface and discuss the need for further investigation on the subject.
Tenkate, Thomas D
I read with interest a recent paper in your journal by Slagor et al on the risk of cataract in relation to metal arc welding (1). The authors highlight that even though welders are exposed to substantial levels of ultraviolet radiation (UVR), "no studies have reported data on how much UVR welders' eyes are exposed to during a working day. Thus, we do not know whether welders are more or less exposed to UVR than outdoor workers" (1, p451). Undertaking accurate exposure assessment of UVR from welding arcs is difficult, however, two studies have reported ocular/facial UVR levels underneath welding helmets (2, 3). In the first paper, UVR levels were measured using polysulphone film dosimeters applied to the cheeks of a patient who suffered from severe facial dermatitis (2). UVR levels of four times the American Conference of Governmental Industrial Hygienists (ACGIH) maximum permissible exposure (MPE) (4) were measured on the workers left cheek and nine times the MPE on the right cheek. The authors concluded that the workers dermatitis was likely to have been due to the UVR exposure received during welding. In the other paper, a comprehensive exposure assessment of personal UVR exposure of workers in a welding environment was reported (3). The study was conducted at a metal fabrication workshop with participants being welders, boilermakers and non-welders (eg, supervisors, fitters, machinists). Polysulphone film dosimeters were again used to measure UVR exposure of the workers, with badges worn on the clothing of workers (in the chest area), on the exterior of welding helmets, attached to 11 locations on the inside of welding helmets, and on the bridge and side-shields of safety spectacles. Dosimeters were also attached to surfaces throughout the workshop to measure ambient UVR levels. For welding subjects, mean 8-hour UVR doses within the welding helmets ranged from around 9 mJ/cm 2 (3×MPE) on the inside of the helmets to around 15 mJ/cm 2 (5×MPE) on the headband (a
Cromwell, R. L.; Zanello, S. B.; Yarbough, P. O.; Taibbi, G.; Vizzeri, G.
/D) ratio. For all measures, there was no significant difference between subject groups for pre-bed rest testing. Post bed rest values also remained similar between groups. Comparison of pre- to post bed rest testing within each group did not demonstrate any statistical differences. These preliminary results from 14-day bed rest studies suggest that the combination of exercise and horizontal bed rest as compared to 6 degrees HDT bed rest did not produce differences in the ocular response with regard to IOP and optic disc parameters. The ocular measures reported here only included pre- and post bed rest time points. Further investigation is needed to examine both the acute response and long term adaptation of structural and functional ocular parameters in the bed rest platform and determine its usefulness for studying spaceflight phenomena. From a clinical perspective, the ability to study ocular responses in the controlled environment of the bed rest platform can provide valuable information for the care of patients restricted to bed rest.
Paley, Grace L; Echalier, Elizabeth; Eck, Thomas W; Hong, Augustine R; Farooq, Asim V; Gregory, Darren G; Lubniewski, Anthony J
To report cases of acute globe rupture and bilateral corneal burns from electronic cigarette (EC) explosions. Case series. We describe a series of patients with corneal injury caused by EC explosions. Both patients suffered bilateral corneal burns and decreased visual acuity, and one patient sustained a unilateral corneoscleral laceration with prolapsed iris tissue and hyphema. A review of the scientific literature revealed no prior reported cases of ocular injury secondary to EC explosions; however, multiple media and government agency articles describe fires and explosions involving ECs, including at least 4 with ocular injuries. Given these cases and the number of recent media reports, ECs pose a significant public health risk. Users should be warned regarding the possibility of severe injury, including sight-threatening ocular injuries ranging from corneal burns to full-thickness corneoscleral laceration.
Naduvilath, Thomas; Papas, Eric B; Lazon de la Jara, Percy
To determine if rating of ocular comfort during soft contact lens wear is affected by demographic factors. Retrospective analysis of ocular comfort ratings during soft contact lens wear extracted from 44 nonrandomized similar clinical trials (n = 986). Subjects wore one of seven daily wear silicone hydrogels (SiHy) in combination with one of nine lens care products (LCP), and two daily disposables lenses. The effects on comfort rating of demographic factors were examined after adjusting for lens and LCP effects using general linear model. Males reported lower comfort on insertion than females (7.9 ± 1.6 vs. 8.1 ± 1.6, p = 0.001). Over 45 years old had higher comfort ratings than those between 26 and 45 or gender, lens wear experience, ethnicity, and refractive status can influence the rating of ocular comfort in clinical studies. The confounding effects of such demographic factors can be controlled by implementing randomization and appropriate multivariable statistical analysis.
Shiramizu, Kevin M; Kreiger, Allan E; McCannel, Colin A
To report two cases of ocular perforation during chalazion removal procedures leading to severe vision loss. Observational case series. Two patients presented with unilateral decreased vision after chalazion removal procedures. Complete ophthalmologic examinations were performed. Examination revealed a cherry red spot and perforation site in the first patient. In the second patient, there was an intraocular gas bubble and ischemic retina. Local anesthetic injections for procedures such as chalazia removal can result in ocular perforation. We postulate that the intraocular injections led to extremely high pressures, compromising the blood supply to the retina and optic nerve. Anesthetic injections for all procedures, even chalazia removal, should be done with great caution. It is imperative to avoid injection if ocular perforation is suspected, as the high pressure may cause the majority of the visual morbidity.
Shivcharan L Chandravanshi
Full Text Available The Hutchinson-Gilford progeria (HGP syndrome is an extremely rare genetic condition characterized by an appearance of accelerated aging in children. The word progeria is derived from the Greek word progeros meaning ′prematurely old′. It is caused by de novo dominant mutation in the LMNA gene (gene map locus 1q21.2 and characterized by growth retardation and accelerated degenerative changes of the skin, musculoskeletal and cardiovascular systems. The most common ocular manifestations are prominent eyes, loss of eyebrows and eyelashes, and lagophthalmos. In the present case some additional ocular features such as horizontal narrowing of palpebral fissure, superior sulcus deformity, upper lid retraction, upper lid lag in down gaze, poor pupillary dilatation, were noted. In this case report, a 15-year-old Indian boy with some additional ocular manifestations of the HGP syndrome is described.
Full Text Available Brucellosis is a zoonotic disease with widespread prevalence. It presents with in various range and often with the presence of non-specific clinical signs and symptoms. Brucellosis also may cause different manifestations in eyes such as uveitis, keratitis, conjunctivitis and neuro-ophthalmic defects. Ocular brucellosis is rare among children. Herein, we present a 7-year-old girl with systemic and ocular brucellosis. After treatment with systemic steroid and antibiotics, her signs and symptoms disappeared. Since early treatment is important in preventing permanent visual loss and the other complications of ocular brucellosis, examination of the eyes in brucellosis patients must always be noticed by clinicians working in this field.
Full Text Available The ocular insert represents a significant advancement in the therapy of eye disease. Ocular inserts are defined as sterile, thin, multilayered, drug-impregnated, solid or semisolid consistency devices placed into the cul-de-sac or conjuctival sac, whose size and shape are especially designed for ophthalmic application. They are composed of a polymeric support that may or may not contain a drug. The drug can later be incorporated as dispersion or a solution in the polymeric support. They offer several advantages as increased ocular residence and sustained release of medication into the eye. The insert includes a body portion sized to position within a lachrymal canaliculus of the eyelid. The inserts are classified according to their solubility as insoluble, soluble, or bioerodible inserts. The release of drug from the insert depends upon the diffusion, osmosis, and bioerosion of the drug, and this article is an attempt to present a brief about this newer drug delivery system.
Misra, Stuti L; Braatvedt, Geoffrey D; Patel, Dipika V
Although diabetes mellitus is reaching epidemic proportions worldwide, ocular surface complications are still largely believed to be uncommon. Although these complications are not often sight threatening, the general well-being of patients and the cost of their health care can be respectively compromised and added by them. Over the last decade, an association of ocular surface complications (in particular reduced corneal sub-basal nerve density and corneal sensitivity) with peripheral neuropathy has emerged, which could help recognize the development of peripheral complications at an earlier stage and also provide research opportunities for examining new treatment modalities of diabetic neuropathies. The ocular surface complications of diabetes mellitus and their association with peripheral neuropathy are reviewed by this report. © 2015 Royal Australian and New Zealand College of Ophthalmologists.
Ramstead, Cory; Ng, Mancho; Rudnisky, Christopher J
As Airsoft guns have gained popularity in Canada, there have been an increasing number of associated ocular injuries. This study reviews and evaluates the ocular injuries and effects associated with trauma secondary to Airsoft guns. The clinical records of 1232 patients seen by an on-call ophthalmology resident at the Royal Alexandra Hospital Eye Clinic were reviewed. Of these, 8 patients had ocular injuries involving an Airsoft gun. All 8 cases were monocular injuries in male patients with a mean age of 18 years. Documented injuries included hyphema, corneal contusion, subconjunctival hemorrhage, lid contusion, corneal abrasion, traumatic iritis, commotio retinae, and traumatic mydriasis. Presenting visual acuities ranged from 20/15 to light perception. Injuries were confined mostly to the anterior segment and were not as serious as injuries reported from paintball and traditional BB gun injuries. However, hyphema was a commonly observed finding. Eye care professionals should be aware of the potential harm associated with injuries related to Airsoft guns.
Sayed-Ahmed, Ibrahim O; Palioura, Sotiria; Galor, Anat; Karp, Carol L
Topical chemotherapy has gained popularity among clinicians for the treatment of ocular surface squamous neoplasia (OSSN). The principal topical chemotherapy agents used in the management of OSSN are interferon-α2b, 5-fluorouracil, and mitomycin C. High-resolution optical coherence tomography (HR-OCT) is a non-invasive technique that can differentiate OSSN from other ocular surface lesions. This review highlights the current regimens and diagnostic modalities used in managing OSSN. A review of the literature was performed using the keywords "conjunctival intraepithelial neoplasia", "ocular surface squamous neoplasia", "optical coherence tomography", "interferon-α2b", "5-fluorouracil" and "mitomycin C". Topical chemotherapy for OSSN can be used as primary therapy, for chemoreduction prior to surgical excision, and postoperatively to prevent tumor recurrence. It has the advantage of treating microscopic disease as well as large tumors. HR-OCT provides an "optical biopsy" that can assist in diagnosis and guide management of OSSN lesions.
Lee, Andrew G; Mader, Thomas H; Gibson, C Robert; Tarver, William
New and unique physiologic and pathologic systemic and neuro-ocular responses have been documented in astronauts during and after long-duration space flight. Although the precise cause remains unknown, space flight-associated neuro-ocular syndrome (SANS) has been adopted as an appropriate descriptive term. The Space Medicine Operations Division of the US National Aeronautics and Space Administration (NASA) has documented the variable occurrence of SANS in astronauts returning from long-duration space flight on the International Space Station. These clinical findings have included unilateral and bilateral optic disc edema, globe flattening, choroidal and retinal folds, hyperopic refractive error shifts, and nerve fiber layer infarcts. The clinical findings of SANS have been correlated with structural changes on intraorbital and intracranial magnetic resonance imaging and in-flight and terrestrial ultrasonographic studies and ocular optical coherence tomography. Further study of SANS is ongoing for consideration of future manned missions to space, including a return trip to the moon or Mars.
Chan, Lawrence S
Mucous membrane pemphigoid, a heterogeneous group of autoimmune blistering diseases, affects primarily the mucous membranes. Although oral and ocular mucosae can both be affected in a given patient, patients with involvement restricted to oral mucosae tend to have a benign outcome, whereas those with ocular disease commonly face treatment resistance, resulting in scarring and blindness. Diagnosis requires direct immunofluorescence microscopy to demonstrate a linear deposition of immunoglobulin (Ig) G or IgA, or complement component 3 (C3), at the epithelial basement membrane. Although the target antigens vary, subsets of patients affected exclusively by oral and ocular mucosal diseases have autoantibodies targeting α-6 and β-4 integrins, respectively. Copyright © 2012 Elsevier Inc. All rights reserved.
Eliane Terumi Inada
Full Text Available O objetivo desse trabalho é relatar um caso de toxicidade ocular pelo tamoxifeno. Para isso, aferiu-se a melhor acuidade visual corrigida de ambos os olhos em tabela de Snellen. Foram realizados biomicroscopia do segmento anterior, refração, oftalmoscopia, angiofluoresceinografia e retinografia numa paciente de 63 anos, sexo feminino, cor branca, em uso de tamoxifeno 20 mg/dia há 4 anos, com acuidade visual corrigida de 20/70 e 20/40. A biomicroscopia do segmento anterior apresentava ceratopatia verticilata e catarata nuclear e cortical posterior de 1+/4 em ambos os olhos. À oftalmoscopia, foi verificado alteração do brilho macular de ambos os olhos. E a angiofluoresceinografia mostrou hiperfluorescência na área macular em fase precoce (defeito em janela. Relata-se um caso de ceratopatia e maculopatia causadas pelo tamoxifeno.To report tamoxifen ocular toxicity. The best visual acuity was measured in both eyes with Snellen chart, slit-lamp examination of anterior segment, refraction, dilated fundus examination, fluorescein angiography and retinography in a 63-year-old patient, female, white, using tamoxifen 20 mg/day for 4 years, with 20/70 and 20/40 corrected visual acuity. The anterior segment examination showed corneal linear subepithelial opacity inferior to the visual axis and nuclear and posterior cortical cataract (1+/4 in both eyes. Fundus examination showed alteration of macular color in both eyes. Fluorescein angiography presented hyperfluorescence in the macular area at an early phase (window defect. Report of keratopathy and maculopathy caused by tamoxifen.
Kotecha, Aachal; Russell, Richard A; Sinapis, Angelos; Pourjavan, Sayeh; Sinapis, Dimitros; Garway-Heath, David F
...) and corneal response factor (CRF) and ocular dimensions, age and intraocular pressure. Two hundred and twelve eyes of 212 participants with no ocular pathology had CH and CRF measured with the ORA...
del Pozo, Jose L.; van de Beek, Diederik; Daly, Richard C.; Pulido, Jose S.; McGregor, Christopher G. A.; Patel, Robin
BACKGROUND: Ocular infections associated with organ transplantation are well documented following renal and liver transplantation; however, few studies have reported ocular infections following heart transplant. METHODS: We retrospectively studied patients who underwent heart transplantation in the
Andrés J.M. Ferreri; Maurilio Ponzoni; Massimo Guidoboni; Carlo De Conciliis; Antonio Giordano Resti; Benedetta Mazzi; Antonia Anna Lettini; Judit Demeter; Stefania Dell'Oro; Claudio Doglioni; Eugenio Villa; Mauro Boiocchi; Riccardo Dolcetti
.... Chlamydia psittaci DNA has been detected in 80% of ocular adnexal lymphomas. The present pilot study was carried out to assess whether C psittaci-eradicating antibiotic therapy is associated with tumor regression in ocular adnexal lymphomas...
Conclusions: This review shows the diverse entity of ocular TB spectrum in an endemic area. Good clinical response to anti-tuberculous therapy supported the presumed diagnosis of ocular TB in majority of the cases.
Management of ocular trauma is widely carried out in China presently. Quick development of treatment and research of ocular trauma was achieved in the last five years, and the achievement was inspired. However, we expressly see that there are still a lot of further work to do in the field of epidemiology of ocular trauma, criterions and guidelines for ocular trauma treatment, meticulous treatment of ocular trauma and technique innovation, and research of ocular trauma. The level of prevention and treatment of ocular trauma should be increased stably so long as the direction is right and the performance is earnest. Meanwhile, the academic status and impact of Chinese ocular trauma field can be elevated in the world consequently.
National Aeronautics and Space Administration — Advanced Diagnostics and Prognostics Testbed (ADAPT) Project Lead: Scott Poll Subject Fault diagnosis in electrical power systems Description The Advanced...
Full Text Available Adaptive skills are defined as a collection of conceptual, social and practical skills that are learned by people in order to function in their everyday lives. They include an individual's ability to adapt to and manage her or his surroundings to effectively function and meet social or community expectations. Good adaptive skills promote individual's independence in different environments, whereas poorly developed adaptive skills are connected to individual's dependency and with greater need for control and help with everyday tasks. Assessment of adaptive skills is often connected to assessment of intellectual disability, due to the reason that the diagnosis of intellectual disability includes lower levels of achievements on standardized tests of intellectual abilities as well as important deficits in adaptive skills. Assessment of adaptive behavior is a part of standard assessment battery with children and adults with different problems, disorders or disabilities that affect their everyday functioning. This contribution also presents psychometric tools most regularly used for assessment of adaptive skills and characteristics of adaptive skills with individual clinical groups.
Magalhães, Fernanda Pedreira; Hirai, Flavio Eduardo; de Sousa, Luciene Barbosa; de Oliveira, Lauro Augusto
To report the outcomes of Boston type I keratoprosthesis (BKPro) in the management of ocular burn injuries. This was a prospective study including all cases of BKPro implantation for ocular burns at the External Diseases and Cornea Service of the Federal University of São Paulo, between February 2008 and February 2010. Ten patients (10 eyes) were enrolled. Procedures performed to manage ocular injury were identified, and data were collected regarding patients' ocular history, surgical procedure(s) performed, and postoperative outcomes, including visual acuity, retention, complications and required surgical procedures. A total of 11 Type 1 BKPro were implanted in 10 eyes of 10 patients. The mean follow-up period was 25.7 ± 10.8 months. Preoperative best-corrected visual acuity (BCVA) ranged from count fingers to light perception. Postoperative BCVA was better than 20/200 in 90% of the patients and better than 20/60 in 60% of the patients. The overall BKPro retention rate was 90%. The most common complications were retroprosthetic membrane formation (50%) and persistent corneal epithelial defect evolving to corneal melting (40%). Patients who underwent ocular surface procedures such as limbal transplantation prior to BKPRo implantation had a lower incidence of corneal melting/thinning (p = 0.07), although this was not statistically significant. The anatomical and functional results identified in this study support the use of BKPro in managing bilateral limbal stem cell deficiency secondary to ocular burns. © 2013 The Authors. Acta Ophthalmologica © 2013 Acta Ophthalmologica Scandinavica Foundation. Published by Blackwell Publishing Ltd.
Rohrbach, J M; Stiemer, R; Mayer, A; Riedinger, C; Duijvestijn, A; Zierhut, M
Knowledge about immunological features and growth characteristics of palpebral (ocular) basal cell carcinomas (BCCs) is limited. In particular, it is unclear whether ocular BCC represents in this regard a special BCC entity or not. Twenty BCCs of the lid area (ocular BCCs) were investigated immunohistologically using monoclonal antibodies against CD4, CD8, CD45Ro, CD50, CD68, HECA-452, Ki67 (MIB1), and the p53 epitope. For comparison, nine BCCs excised distant from the eye (non-ocular BCCs) were evaluated. In BCCs the distribution of the immunocompetent cells investigated is markedly irregular. These cells are localized mainly around BCC islands. Only a few of them invade tumour cell aggregates. The CD4:CD8 ratio as detected by immunohistochemistry is >1 in 82% of ocular BCCs and in 88% of nonocular BCCs. Often there are dense infiltrations of CD68+ cells (macrophages) and HECA-452+ cells adjacent to tumour cell aggregates. The growth fraction [percentage of proliferating (Ki67+/MIB 1+) cells] varies from 0% to more than 30%. Proliferative activity is enhanced at the invasion front. Additionally, the amount of p53+ cells differs considerably among the BCCs. CD4+ T cells seem to be the most important cell population for BCC immunosurveillance, offering the chance for conservative interferon therapy. The role of CD68+ and HECA-452+ cells has to be further elucidated. In many tumours the large amount of proliferating cells contrasts to the usually slow growth of BCCs, indicating strong apoptotic processes. The results can be regarded only as semiquantitative. So far, ocular and nonocular BCCs exhibit no essential differences regarding immunocompetent cell infiltration and growth characteristics. According to this, palpebral BCCs are "normal" BCCs and not a special BCC variant. Therefore, results from dermatological research concerning BCC can be extended without limitations to their counterparts in the lid area.
Full Text Available PURPOSE: To determine the timing of spontaneous venous pulsation (SVP relative to the ocular circulatory cycle by using the movie tool of confocal scanning laser ophthalmoloscope. METHODS: A video recording of the fundus was obtained using a confocal scanning laser ophthalmoscope (Spectralis HRA, Heidelberg Engineering, Heidelberg, Germany at 8 frames/s in 47 eyes (15 glaucoma patients and 32 glaucoma suspects with visible pulsation of both the central retinal artery (CRA and vein (CRV. The timing of the maximum and minimum diameters of the CRA (CRA(max and CRAmin, respectively and CRV (CRV(max and CRV(min, respectively was identified during four pulse cycles. The interval between CRV(min and CRA(min, and between CRV(max and CRA(max was expressed as the number of frames and as a percentage of the ocular circulatory cycle. RESULTS: The ocular circulatory cycle (from one CRA(max to the next lasted 7.7 ± 1.0 frames (958.8 ± 127.2 ms, mean ± SD, with a mean pulse rate of 62.6 beats/min. The diameter of the CRA was increased for 2.4 ± 0.5 frames (301.9 ± 58.8 ms and decreased for 5.3 ± 0.9 frames (656.9 ± 113.5 ms. CRV(max occurred 1.0 ± 0.2 frames after CRA(max (equivalent to 13.0% of the ocular circulatory cycle, while CRV(min occurred 1.1 ± 0.4 frames after CRA(min (equivalent to 14.6% of the ocular circulatory cycle. CONCLUSIONS: During SVP, the diameter of the CRV began to decrease at early diastole, and the reduction persisted until early systole. This finding supports that CRV collapse occurs during ocular diastole.
Full Text Available To evaluate meibomian gland function, changes of lacrimal tears and ocular surface parameters and tear inflammatory mediators following cataract surgery.48 eyes of 34 patients who underwent uncomplicated phacoemulsification were involved and divided into 2 groups with those who had preexisting dry-eye before cataract surgery and those who did not. Ocular symptom score, Schirmer I test, tear film break-up time (TBUT, corneal sensitivity threshold, corneal staining, inflammatory cytokine activities, lid margin abnormalities, meibum expressibility, meibum quality and meibomian gland imaging were evaluated preoperatively, at 1 day, 1 and 2 months postoperatively.Ocular symptom scores were worse at 1 and 2 months postoperatively but, TBUT, corneal staining score and corneal sensitivity threshold showed gradual improvements at 1 month and 2 months postoperatively (p<0.05, respectively. Interestingly there were statistically significant improvements in TBUT, corneal staining score and corneal sensitivity threshold at 1 month postoperatively when topical eye drops were used compared to the period without topical therapy which is the months 2 postoperatively. There were statistically significant decreases in IL-1β, IL-6, IL-8, MCP-1, TNF-α and IFN-γ concentrations at 1 and 2 months postoperatively. Lid margin abnormalities, meibum quality and expressibility scores increased significantly (p < 0.05, respectively at postoperative period. Compared with the no dry eye group, dry eye group revealed significantly higher ocular symptom scores, lower TBUT, higher lid margin abnormalities, meibum quality and expressibility scores after cataract surgery. There were significant correlations between IL-6 and parameters of dry eye, and between MGD parameters and ocular symptom scores.Our study revealed that meibomian gland function is influenced after cataract surgery accompanying structural changes and these were correlated with increased ocular symptom scores
Lee, Hun; Kim, Eung Kweon; Kang, Sang Won; Kim, Jae Hoon; Hwang, Hye Jeong; Kim, Tae-Im
Changes in the ocular surface induced by ozone have received limited research attention. Here, we investigate the effects of ozone exposure on the integrity of the ocular surface, the production of inflammatory cytokines in tears, and changes in mucin-secreting cells in a mouse model. In addition, ozone-induced nuclear factor-κB (NF-κB)-mediated inflammatory processes were evaluated in cultured human conjunctival epithelial cells. In vivo, ozone induced the breakdown of corneal epithelial integrity, decreased the number of mucin-secreting cells, and induced the production of inflammatory cytokines, without altering tear volume. In vitro, ozone exposure led to increases in NF-κB nuclear translocation, κB-dependent transcriptional activity, NF-κB inhibitor α (IκBα) proteolysis, and expression of phosphorylated IκBα (p-IκBα), but did not cause cytotoxicity or cellular apoptosis. In addition, ozone induced the expression of inflammatory cytokines, Toll-like receptors, and C-C chemokine receptors, but decreased the expression of mucins. Furthermore, inhibition of NF-κB with pyrrolidine dithiocarbamate before exposure of cultured human conjunctival epithelial cells to ozone prevented changes in IκBα and p-IκBα levels in association with a decrease in the levels of inflammatory cytokines. Therefore, we conclude that ozone exposure interferes with ocular surface integrity and induces inflammation involving NF-κB-mediated processes at the level (and/or upstream) of IκBα. Understanding the role of ozone in the initiation of inflammatory processes on the animal ocular surface and in cultured human conjunctival epithelial cells can help elucidate the pathogenesis of ocular surface damage and suggest protective strategies for preserving a healthy ocular surface against ozone exposure. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.
Jafari, Alireza Keshtkar; Anvari, Faramarz; Ameri, Ahmad; Bozorgui, Shima; Shahverdi, Nooshin
Although the incidence of ocular trauma has been clearly described in developed countries, few published data are available on the epidemiology and the effects of parameters that can influence the incidence and severity of ocular injuries in Iran. The present study tried to determine epidemiological aspects of ocular traumatic injuries and evaluate their effects on different types of ocular injury. The case series included 1950 consecutive patients with acute ophthalmic trauma presented to the emergency ward of Farabi Hospital in Tehran. Information was collected by interviewing patients and having them fill in a questionnaire. The final diagnosis was made by a medical resident. If there was a difficulty or doubt in diagnosis or classification, confirmation of diagnosis was made by senior faculty. Ocular injuries were classified into globe and non-globe injuries according to the site of injury. Mechanical globe injuries were classified according to Birmingham Eye Trauma Terminology (BETT) into closed and open injuries. The mean age of patients was 28.8 ± 12.8 years; 87.6% were male. The most common causes of injury were work-related (49.0%) and chance events (42.0%). The most frequent ocular injury was globe injury (95.6%), including mechanical (77.6% closed and 5.9% open), chemical (7.6%), photic (2.3%) and thermal (2.2%) injuries. Non-globe injury also occurred in 10.8% of patients; both globe and non-globe injuries occurred in 6.5% of patients. The hospitalization rate in all patients was 8.8%. Previous history of eye trauma was significantly more common in the group with isolated globe injuries (P < 0.001). History of eye trauma is a risk factor for globe injuries and female gender is a risk factor only for non-globe injuries. These two factors may predict future eye injury and increase its risk by 5.2 and 1.6 times, respectively.
Full Text Available The World Health Organization has declared tuberculosis (TB to be a global emergency, as it remains the most common single cause of morbidity and mortality worldwide. TB is caused by the acid-fast bacillus Mycobacterium tuberculosis and primarily affects the lungs [pulmonary TB (PTB]. It can also affect any other part of the body [extrapulmonary TB (EPTB]. It is estimated that 1.4% of patients with PTB will eventually develop ocular disease; however, in the majority of cases of ocular TB, PTB may not be documented. Ocular TB infection is usually a result of hematogenous spread during PTB or EPTB. Symptomatic disease most commonly develops after reactivation of dormant foci in the ocular tissue rather than being the manifestation of the initial infection. Immune-mediated ocular TB can occur due to hypersensitivity to M. tuberculosis antigens from a distant focus (such as lungs, despite the absence of the bacterium in the eye. The most common clinical presentation of intraocular inflammation (uveitis due to TB appears to be posterior uveitis, followed by anterior uveitis, panuveitis and intermediate uveitis. The absence of uniform diagnostic criteria for intraocular TB has led to confusion regarding its diagnosis and management. Recent studies on the clinical importance of purified protein derivative (PPD skin test, interferon-gamma release assays, chest computed tomography and polymerase chain reaction have provided a new approach to diagnosing ocular TB. This review series focuses on the clinical features, diagnostic techniques, diagnostic criteria, and treatment modalities in the light of recent literature. (Turk J Ophthalmol 2011; 41: 171-81
Holve, Dana L; Mundwiler, Karen E; Pritt, Stacy L
Laboratory rabbits are commonly used for ocular drug and device studies. The purpose of this study was to determine the incidence of spontaneous ocular lesions in laboratory rabbits with respect to sex, breed, and supplier. We retrospectively evaluated ophthalmic examination records of rabbits screened between April 2008 and April 2010. These 1840 records represented 572 black Dutch belted (DB), 1022 New Zealand white (NZW), and 246 NZW × New Zealand red F1 crosses (WRF1). Rabbits were between 6 and 16 wk of age and had been received from 5 suppliers. Ocular structures evaluated were the cornea, lens, iris and vitreous with respect to sex, breed and supplier. A total of 177 rabbits (9.6%) and 233 eyes (6.3%) were effected. Of total rabbits, 15.3% males and 7.3% females were affected. The most common structure affected was the cornea in 5.7% of rabbits, (DB 11.7%, NZW 3.0%, and NZR 3.3%). The lens at 3.6% was second most common (DB 2.1%, NZW 4.6%, and NZR 3.3%). Both iris (0.2%) and vitreous (0.3%) were not significantly affected. Significant sex-breeder-supplier combinations were: cornea DB supplier D, supplier D females, supplier D males, DB males and NZR females; and lens: NZW females; and at least one affected ocular structure: NZW supplier D, supplier D females, DB males, NZW females, and NZR females. Breed, sex, and supplier were significant variables of ocular lesions in laboratory rabbits. Investigators should consider each of these variables when choosing rabbits for ocular studies. PMID:22330351
Miserocchi, Elisabetta; Iuliano, Lorenzo; Berchicci, Luigi; Bandello, Francesco; Modorati, Giulio
The aim of this study was to evaluate tear film osmolarity in patients with ocular mucous membrane pemphigoid (MMP). This observational cross-sectional study included 40 patients with biopsy-proven ocular MMP at Foster stage III referred to the tertiary-care Ocular Immunology and Uveitis Service at the San Raffaele Scientific Institute in Milan from June 2010 to August 2013. We evaluated the following clinical parameters: tear film osmolarity, ocular surface disease symptoms (OSDI) questionnaire, Schirmer test, tear film break-up time (TFBUT), and corneal and conjunctival staining. Forty patients (27 women and 13 men) were enrolled. All patients were undergoing systemic immunosuppressive therapy: 19 patients (47.5%) were on methotrexate, 9 (22.5%) were on mycophenolate mofetil, 9 (22.5%) were on low-dose corticosteroids, and 3 (7.5%) were on azathioprine. The mean osmolarity was 322.90 ± 33.39 mOsm/L, the mean OSDI score was 73.2 ± 17.9, the mean TFBUT was 6.60 ± 3.13 seconds, and the mean Schirmer test value was 4.07 ± 3.58 seconds. Tear film osmolarity significantly correlated with the TFBUT (r = 0.80; P < 0.0001), whereas no clinical correlation was found with the Schirmer test value (r = 0.01; P = 0.40) or with the OSDI score (r = 0.02; P = 0.29). Osmolarity did not turn out to be statistically different in the subgroups according to the Oxford corneal staining scale (P = 0.71) and to the Van Bijsterveld conjunctival staining score (P = 0.31). Tear osmolarity increased in patients with ocular MMP and correlated with the TFBUT. This result emphasizes the role of evaporative dry-eye condition in patients with ocular MMP. Tear osmolarity may be considered as a useful test in the diagnostic assessment of dry eye associated with MMP and for targeting therapeutic decisions.
Fukuhara, Daisuke; Takiura, Toshihiko; Keino, Hiroshi; Okada, Annabelle A; Yan, Kunimasa
Iatrogenic Cushing's syndrome (CS) is a severe adverse effect of systemic glucocorticoid (GC) therapy in children, but is extremely rare in the setting of topical ocular GC therapy. In this article, we report the case of a 9-year-old girl suffering from idiopathic uveitis who developed CS due to topical ocular GC treatment. She was referred to the ophthalmology department with a complaint of painful eyes, at which time she was diagnosed with bilateral iridocyclitis and started on a treatment of betamethasone sodium phosphate eye drops. Six months after the initiation of topical ocular GC treatment, she was referred to our pediatric department with stunted growth, truncal obesity, purple skin striate, buffalo hump, and moon face. Because her serum cortisol and plasma adrenocorticotropic hormone levels were undetectable, she was diagnosed with iatrogenic CS. After the doses of topical ocular GC were reduced, the clinical symptoms of CS were improved. The fact that the amount of topical ocular GC with our patient was apparently less than that of similar previous cases tempted us to perform genetic analysis of her NR3C1 gene. We found that our patient had a single heterozygous nucleotide substitution in the 3' untranslated region of the NR3C1 gene, which may explain why she developed CS. However, additional investigations are required to determine if our findings can be extrapolated to other patients. In conclusion, clinicians should be aware that even extremely low doses of topical ocular steroid therapy can cause iatrogenic CS. Copyright © 2017 by the American Academy of Pediatrics.
Venkatesh, Pradeep; Selvan, Harathy; Singh, Sundararajan Baskar; Gupta, Divya; Kashyap, Seema; Temkar, Shreyas; Gogia, Varun; Tripathy, Koushik; Chawla, Rohan; Vohra, Rajpal
To report the unique clinical and surgical characteristics encountered in eyes with vitreous amyloidosis. Systemic evaluation and visual outcome after vitrectomy are discussed. A novel mutation in the transthyretin gene (TTR) in Indian patients with familial amyloid polyneuropathy (FAP) is described. Retrospective, observational study. Ten eyes of 5 patients from 2 pedigrees with a diagnosis of vitreous amyloidosis. Detailed history, pedigree charting, systemic and ocular examination of 10 eyes (5 patients from 2 pedigrees) were carried out. Tests were performed to rule out vitreitis, retinal vasculitis, vitreous hemorrhage, and systemic amyloidosis. Genetic analysis to identify the mutation was performed in 1 patient. Vitreous biopsy, followed by 25-gauge pars plana vitrectomy, was performed in the same sitting in all cases. Samples were sent for Congo red staining and polarized microscopy. Patients were followed up on days 1, 7, and 28 and then every 2 months. Visual acuity assessment, intraocular pressure measurement, and fundus examination were performed each time. Mutations in TTR and postoperative visual acuity. Mean age at presentation was 32 years, with a 3:2 male-to-female distribution. Family history was positive in all patients. Nine eyes had pseudopodia lentis, whereas all 10 had glass wool-like vitreous. Glaucoma developed in 1 patient (2 eyes). Waxy paper-like vitreous with firm vitreous adhesions beyond major arcades and along retinal vessels was noted during surgery in all eyes. Congo red staining and apple green birefringence demonstrated vitreous amyloidosis. The mean preoperative best-corrected visual acuity (BCVA) was 1.39±0.64 logarithm of the minimum angle of resolution (logMAR), whereas the postoperative BCVA improved to 0.17±0.07 logMAR (P = 0.004). Gene sequencing revealed a phenylalanine→isoleucine mutation in the 33rd position of exon 2 of TTR in 1 patient of 1 pedigree, confirming the diagnosis of FAP. Two patients subsequently
Nara Lúcia Poli Botelho
ão fortalecidos. A prótese exerce dupla função, pois de um lado devolve ao paciente sua auto-imagem e auto-estima, possibilitando sua reintegração psicossocial, enquanto por outro lado, pode tornar-se um instrumento que afasta a possibilidade da perda ser vivenciada em sua totalidade, contribuindo para que esses indivíduos adotem atitudes de repressão diante da realidade instalada. Não há relação direta entre o resultado estético obtido com o grau de satisfação do paciente. O preconceito é outro fator importante, pois pode interferir ou não na reabilitação do sujeito, dependendo do comportamento que apresente diante da sociedade.PURPOSE: To evaluate psychological disturbances caused by acquired unilateral anophthalmia, the struggle for aesthetic recuperation on use of the ocular prosthesis, as well as involved interpersonal factors and psychosocial reintegration of these patients. METHOD: Thirty (30 patients with acquired unilateral anophthalmia without any other deformities in the orbital region and users of ocular prosthesis (16 males, 14 females aged between 12 and 66 years, mean age 31.6 years, were submitted to an ophthalmic examination and psychological evaluation through a standardized questionnaire focusing on 66 questions lasting two hours in the period from January, 2000 to March, 2001. RESULT: The highest incidence of acquired anophthalmia (47% was in the age ranging from 0 to 6 years old. Seventy (70% of the patients are in the process of elaboration of their loss (n=21. The most used mechanisms of defense in the current situation were rationalization, repression, denial and displacement. Thirty (30% accept the present situation. After the triggering event (TE 36% manifested a depressive state 64% of whom got over the symptoms of depression. Sixty percent (60% adapted the ocular prosthesis right after the surgical treatment while 40% adapted it two or more years after the TE. Aesthetically 70% are satisfied while 30% are unsatisfied. Fifty-three (53
Full Text Available Various ocular surface disorders like alkali burns and corneal ulcers can all cause damage to the cornea and conjunctiva, and often induce corneal neovascularization(CNVthat affects the visual function. However, amniotic membranes(AMcan promote the rapid epithelization of acute injured corneas and conjunctiva defects, diminish scarring, and perform anti-inflammatory effect. Therefore, AM has been widely used in ocular surface reconstructions and treatment of CNV. But the key problem is how to fix the AM. Only ensuring the adhesive time and cover area with convenient operation and little stimulation can achieve the best curative effect. This article reviews the methods of AM fixation in AM patch technique.
Lee, Y; Yalkowsky, S H
In previous reports (Lee et al., 1997b; Lee and Yalkowsky, 1999), it has been shown that insulin, delivered by an acidified Gelfoam (absorbable gelatin sponge, USP) based ocular device, can be efficiently absorbed into the systemic circulation without the aid of an absorption enhancer. The role of acid in the enhancer-free absorption of insulin is investigated in this report. Gelfoam ocular devices containing 0.2 mg of sodium insulin prepared with either water or 10% acetic acid were evaluated in rabbits. The results suggest that a change in the Gelfoam upon treatment with acid is responsible for the efficient systemic absorption of insulin from these enhancer-free devices.
Aiello, Francesco; Palma, Stefano; Varesi, Chiara; Cerulli, Angelica; Valente, Rosanna; Aiello, Luigi
We report a case of ocular worm treated surgically and confirmed by microbiological identification. A 33-year-old Swiss woman presented to the ophthalmic unit, complaining of pain and foreign body sensation in the left eye. Slit-lamp examination disclosed a subconjunctival amber -colored cord in the conjunctival fornix. Presentation, clinical and histopathologic evaluation, and treatment are described. At the time of surgery, an alive and still intact worm was extracted through conjunctival incision. Histopathology confirmed the presence of filariasis. As the flow of immigrants from endemic areas of Europe increases, ocular manifestation of loiasis is becoming more frequent and ophthalmologists need to be aware of this diagnosis.
Wang, Jenny; Sramek, Christopher; Paulus, Yannis M.; Lavinsky, Daniel; Schuele, Georg; Anderson, Dan; Dewey, David; Palanker, Daniel V.
Application of femtosecond lasers to cataract surgery has added unprecedented precision and reproducibility but ocular safety limits for the procedure are not well-quantified. We present an analysis of safety during laser cataract surgery considering scanned patterns, reduced blood perfusion, and light scattering on residual bubbles formed during laser cutting. Experimental results for continuous-wave 1030 nm irradiation of the retina in rabbits are used to calibrate damage threshold temperatures and perfusion rate for our computational model of ocular heating. Using conservative estimates for each safety factor, we compute the limits of the laser settings for cataract surgery that optimize procedure speed within the limits of retinal safety.
Üstyol, A; Kökali, F; Duru, N; Duman, M A; Elevli, M
Cases of Cushing's syndrome (CS) following ocular steroid use have been reported in recent years, albeit rarely. We report a case of iatrogenic CS in a child induced by fluorometholone-containing eyedrops. Our patient was referred to our endocrinology clinic due to rapid weight gain. His history revealed that 1.5 months previously he had been started on fluorometholone eyedrops. To the best of our knowledge, no cases of CS have been reported following ocular fluorometholone use. Although eyedrops containing potent glucocorticoids may lead to CS, fluorometholone, a relatively less potent steroid, may also cause the syndrome, as in our case. © 2017 John Wiley & Sons Ltd.
Demartini, Zeferino; Liebert, Fernando; Gatto, Luana Antunes Maranha; Jung, Thiago Simiano; Rocha, Carlos; Santos, Alex Marques Borges; Koppe, Gelson Luis
Unilateral carotid cavernous fistula presents with ipsilateral ocular findings. Bilateral presentation is only seen in bilateral fistulas, usually associated with indirect (dural) carotid cavernous fistulas. Direct carotid cavernous fistulas are an abnormal communication between the internal carotid artery and the cavernous sinus. They typically begin with a traumatic disruption in the artery wall into the cavernous sinus, presenting with a classic triad of unilateral pulsatile exophthalmos, cranial bruit and episcleral venous engorgement. We report the case of a 38-year-old male with traumatic right carotid cavernous sinus fistula and bilateral ocular presentation successfully treated by interventional neuroradiology.
Full Text Available ABSTRACT The cornea, conjunctiva and the limbus comprise the tissues at the ocular surface. All of them are covered by stratified, squamous, non-keratinising epithelium and a stable tear film. The ocular surface health is ensured by intimate relationship between ocular surface epithelia and the preocular tear film. It is essential to establish accurate diagnosis for appropriate management of complex ocular surface disorders. Management has improved with introduction of the limbal stem cell concept and amniotic membrane transplantation.
Glaucoma, maculopathy and optic atrophy were causes of severe visual impairment or blindness in 1.9% of the subjects. Absenteeism and clinic use were more common in subjects with ocular morbidity than those with non-ocular morbidity. Subjects with ocular morbidity had more illnesses, absenteeism and used the clinic ...
May 24, 2010 ... that the kidney, femoral muscle, femur and brain of rabbits ocularly exposed to Cd had a significantly higher ... significantly change after three months of exposure to ocular Cd, except plasma ALP activity which remained ..... Concentration of cadmium in the tissues of rabbits after oral and ocular exposure.
Switaj, Karolina; Master, Adam; Borkowski, Piotr Karol; Skrzypczak, Magdalena; Wojciechowicz, Jacek; Zaborowski, Piotr
Toxoplasma gondii strains were genotyped directly from blood samples of patients with ocular toxoplasmosis. Analysis of nontranscribed spacer 2 revealed that all detected strains belonged to type I, suggesting an association of ocular toxoplasmosis with this type. The method shows the usefulness of blood samples for genotyping in ocular toxoplasmosis.
Atallah, Marwan; Joag, Madhura; Galor, Anat; Amescua, Guillermo; Nanji, Afshan; Wang, Jianhua; Perez, Victor L; Dubovy, Sander; Karp, Carol L
Coexistence of an ocular surface disease can mask the typical features of ocular surface squamous neoplasia (OSSN). The purpose of this study was to evaluate high resolution optical coherence tomography (HR-OCT) as an adjunct in the detection and differentiation of OSSN within coexisting ocular surface pathologies. Retrospective study of 16 patients with ocular surface disease and lesions suspicious for OSSN that were evaluated with HR-OCT. HR-OCT images of the lesions were taken to look for evidence of OSSN. Biopsies were performed in all cases, and the HR-OCT findings were compared to the histological results. Of the 16 patients with OSSN and a coexisting ocular surface disease, 12 were found to have OSSN by HR-OCT and all were subsequently confirmed by biopsy. Two patients had OSSN with rosacea, one with pingueculum, two within pterygia, one with Salzmann' nodular degeneration, six with limbal stem cell deficiency (LSCD)/scarring. In all 12 cases HR-OCT images revealed classical findings of hyper-reflective, thickened epithelium and an abrupt transition from normal to abnormal epithelium. OSSN was ruled out by HR-OCT in four cases (2 Salzmann's, 1 mucous membrane pemphigoid, and 1 LSCD). Negative findings were confirmed by biopsy. HR-OCT was used to follow resolution of the OSSN in positive cases, and it detected recurrence in 1 case. While histopathology is the gold standard in the diagnosis of OSSN, HR-OCT can be used to noninvasively detect the presence of OSSN in patients with coexisting ocular conditions. Copyright © 2017 Elsevier Inc. All rights reserved.
Qian, Ying; Glaser, Tanya; Esterberg, Elizabeth; Acharya, Nisha R
To characterize the level of depression in patients with ocular inflammatory disease and to determine predictors of depression in this population. Prospective cross-sectional survey and medical record review. Participants were consecutive patients with noninfectious ocular inflammatory disease in a university-based tertiary referral center. Subjects were given the self-administered Beck Depression Inventory-II (BDI-II), National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25), and additional supplemental questions. Medical records were reviewed for clinical characteristics. Univariate analyses were conducted to compare clinical characteristics between patients with and without a positive screen for depression, and a multivariate regression model was performed to determine the most significant predictors of depression. Of the 104 participants, 26.9% screened positive for depression with the BDI-II. Of these subjects, only 39.3% had been previously diagnosed with depression. NEI VFQ-25 scores were significantly lower in depressed patients in all subscales except driving and color vision. Predictors of depression were inadequate emotional support, lower visual functioning (VFQ composite score), history of changing immunomodulatory treatment, and current oral corticosteroid use. Depression may be a significant but underrecognized comorbid condition in patients with ocular inflammatory disease. Worse visual function was associated with depression. The authors recommend heightened awareness of potential depression in patients with ocular inflammatory disease. Copyright © 2012 Elsevier Inc. All rights reserved.
Background: Acute head injuries are common in the population. Associated ocular injuries are occasionally encountered and these are of varying nature and outcome. Methods: We reviewed 98 brain computed tomographic results retrospectively. These are cases that were done between Jan. 2013- Jan. 2014. Statistical ...
Ocular surface squamous neoplasia (OSSN) is relatively rare with an incidence of 0.13–1.9/100,000 population. OSSN includes dysplastic lesions involving the squamous epithelium of the conjunctiva or cornea. Epibulbar squamous cell carcinoma and epithelioma have been noted commonly, but cases in which the tumor ...
Herpes zoster ophthalmicus was the commonest ocular disease encountered, occurring in 2.7% of the study population. This is in keeping with reports from other parts of the world. We recommend that young patients presenting with Herpes zoster ophthalmicus, conj unctival Squamuos cell carcinoma and sudden onset.
distance correction, and he had low vision assessment done. The second patient was a 38‑year‑old male driver whose vehicle lost control and hit the concrete wall separating the two sides of the road. He was not wearing spectacles or a seat belt at the time of the accident. He sustained bilateral ocular injuries. The vision in.
Maria Fernanda Abalem de Sá
Full Text Available Relato de um caso de barotrauma ocular bilateral relacionado ao mergulho autônomo, com hemorragia conjuntival e periocular. Alguns conceitos de física e cuidados durante o mergulho são reportados para um melhor entendimento da fisiopatogenia do quadro, de modo que se possa melhor orientar os pacientes quanto à prevenção.
Nalawade, Triveni Mohan; Mallikarjuna, Rachappa M; Anand, Bina M; Shashibhusan, Mayur Anand Kk; Reddy, Vv Subba
The eye is a vital organ for vision and an important component of facial expression. Loss of an eye has a crippling effect physically and psychologically. Especially, in case of a child where it affects the parent too and the approach toward these special children needs to be very special indeed. The construction of an ocular prosthesis for a child is the same as for an adult. A growing child will require periodic enlargement of the prosthesis in order to accompany the expansion of the anophthalmic cavity and it is the only way to esthetically rebuild the anophthalmic socket. Although implant eye prosthesis has superior outcome, due to economic factors it may not be advisable in all patients. Therefore, an acrylic custom-made ocular prosthesis replacement as soon as possible is a good alternative to promote physical and psychological healing for the patient and to improve social acceptance. A case of a custom fabricated ocular acrylic prosthesis using the advantages of digital photography is presented here, which had acceptable fit, retention and improved esthetics with a certain degree of motility in coordination with the contralateral normal eye. How to cite this article: Nalawade TM, Mallikarjuna RM, Anand BM, Anand M, Shashibhusan KK, Subba Reddy VV. Prosthetic Rehabilitation of a Pediatric Patient with an Ocular Defect. Int J Clin Pediatr Dent 2013;6(1):62-65.
process, limited recovery capacity, ocular pathology in pa ents and low func onal capacity in this age group exert nega ve effects on the prognosis14. With aging, the quality of vision worsens due to reasons independent of aging eye diseases. There are many changes significant in the non-diseased eye but the most ...
Liang, Lingyi; Li, Wei; Ling, Shiqi; Sheha, Hosam; Qiu, Weiqiang; Li, Chaoyang; Liu, Zuguo
To evaluate the efficacy of amniotic membrane extract (AME) for ocular chemical burns. Prospective non-comparative interventional case series study. Consecutive 14 eyes of 11 patients with acute or chronic chemical burns, being recruited in one referral centre, received AME topically in combination with traditional treatment. Ocular discomfort, visual acuity, ocular surface inflammation, re-epithelialization, corneal thickness, corneal neovascularization and symblepharon were evaluated. Symptom relieved and ocular surface inflammation reduced dramatically in all eyes. Epithelial defect healed in all eyes with acute burns, in which less than 7 clock hours of limbus was involved, after 16.6 days (1-44 days) AME treatment. AME failed to close the epithelial defect in all eyes with chronic chemical burn coexisting diffuse limbal stem cell deficiency; however, the area of epithelial defect decreased to 58% (11.1%-68.2%) at final visit. During a follow-up period of 8.2 months (6-11 months), visual acuity improved in 12 eyes (86%). There was mild neovascularization in three eyes with grade III and IV acute burns, and slow progress of neovascularization in chronic burns. Mild symblepharon developed in two eyes with grade III and IV acute burns, whereas there was no significant progress of symblepharon in chronic cases. Although it is a preliminary and uncontrolled study, topical application of AME is effective in reducing inflammation, promoting reepithelization in the treatment of chemical burns, especially for mild to moderate acute cases.
Guo, Qing; Pi, Yuli; Dong, Ying; Zhu, Jing
To evaluate the clinical outcomes of tissue-engineered epithelium transplantation for severe ocular surface burns. This was a retrospective observational case series. From October 2005 to May 2011, 19 eyes of 19 patients with grade IV to VI ocular surface burns (Dua Classification) were treated by autologous transplantation of corneal stem cells cultivated on a fibrin gel membrane, with a mean follow-up of 16.2 months (range 12-36 months). Postoperative corneal surface stability, visual acuity (VA), corneal opacity, and neovascularization were evaluated. No corneal perforations occurred and the entire corneal surface was free from epithelial defects in all eyes. At the final follow-up visit, VA in 17 eyes was improved after surgery, with 6 eyes achieving a VA of 20/100 or better. Corneal vascularization was significantly reduced in 17 (89.5%) eyes. Corneal opacity was also improved in 12 (63.2%) eyes. All donor eyes remained healthy. Tissue-engineered epithelium transplantation can promote rapid reepithelialization of the ocular surface, inhibit corneal neovascularization, and improve vision for patients with severe ocular surface burns.
Virender S Sangwan
Full Text Available It has only been a quarter of a century since the discovery of adult stem cells at the human corneo-scleral limbus. These limbal stem cells are responsible for generating a constant and unending supply of corneal epithelial cells throughout life, thus maintaining a stable and uniformly refractive corneal surface. Establishing this hitherto unknown association between ocular surface disease and limbal dysfunction helped usher in therapeutic approaches that successfully addressed blinding conditions such as ocular burns, which were previously considered incurable. Subsequent advances in ocular surface biology through basic science research have translated into innovations that have made the surgical technique of limbal stem cell transplantation simpler and more predictable. This review recapitulates the basic biology of the limbus and the rationale and principles of limbal stem cell transplantation in ocular surface disease. An evidence-based algorithm is presented, which is tailored to clinical considerations such as laterality of affliction, severity of limbal damage and concurrent need for other procedures. Additionally, novel findings in the form of factors influencing the survival and function of limbal stem cells after transplantation and the possibility of substituting limbal cells with epithelial stem cells of other lineages is also discussed. Finally this review focuses on the future directions in which both basic science and clinical research in this field is headed.
Sep 3, 2012 ... The mean ocular volumes was different for either eyeball and sex (in males the right eye was 5289.80 mm3, left eye was 5224.31 mm3; while in females the right eye ..... from human sexual dimorphism in which the male body.
Omoti, A E; Waziri-Erameh, J M; Enock, M E
To determine the ocular disorders in the petroleum industry in Warri, Nigeria. A clinic-based prospective study of the pattern of ocular disorders in workers of the Nigerian National Petroleum Corporation in Warri, Delta state of Nigeria was carried out over a 1-year period. Technical and non-technical workers were interviewed and examined using the Snellen's chart, pen-torch, direct ophthalmoscope, slit-lamp biomicroscope, Perkin's hand-held applanation tonometer, and the Kowa automatic visual field plotter where indicated. A total of 154 technical workers comprising 146 males (94.8%) and eight females (5.2%), and 116 non-technical workers comprising 90 males (77.6%) and 26 females (22.4%) were seen. There was no reported case of ocular trauma. Symptoms suggestive of ocular irritation were much more common in technical workers. Allergic conjunctivitis, pterygium, corneal abrasion, and foreign body on the cornea were significantly more common in technical workers Ppetroleum industry makes the technical workers more prone to allergic conjunctivitis, pterygium, corneal abrasion, and foreign body on the cornea. Protection goggles should be provided for all the technical workers.
Airbag Related Ocular Injuries: A Short Case. Series. Adeola O. Onakoya, Chigozie A. Mbadugha, Olufisayo T. Aribaba. Department of Ophthalmology, Guinness Eye Centre, Lagos University Teaching Hospital, Idi-Araba, PMB 12003, Lagos, Nigeria. Address for correspondence. Dr. Chigozie A. Mbadugha, Lions' Eye ...
Background: Glaucoma is the commonest cause of irreversible blindness in the world. Some glaucoma patients start out as glaucoma suspects for years. Aim: To determine the prevalence of glaucoma suspects and pattern of intra-ocular pressure distribution in glaucoma suspects. Methods: This survey was carried out in ...
Dec 13, 2016 ... customized ocular prosthesis with the help of prosthetics department. Among 35 cases of squamous cell carcinoma, 23 (65.71%) were of limbal origin, 7 (20%) cases were only conjunctival origin and 5 (14.28%) cases were from the lid. The average age of presentation was 24.4 years. Among these 35 ...
Jean B Kassem
Full Text Available Ocular pulse amplitude (OPA is defined as the difference between maximum and minimum intraocular pressure (IOP during a cardiac cycle. Average values of OPA range from 1 to 4 mmHg. The purpose of this investigation is to determine the source of an irregular IOP waveform with elevated OPA in a 48-year-old male. Ocular pressure waveforms had an unusual shape consistent with early ventricular contraction. With a normal IOP, OPA was 9 mmHg, which is extraordinarily high. The subject was examined by a cardiologist and was determined to be in ventricular bigeminy. In addition, he had bounding carotid pulses and echocardiogram confirmed aortic insufficiency. After replacement of the aortic valve, the bigeminy resolved and the ocular pulse waveform became regular in appearance with an OPA of 1.6-2.0 mmHg. The ocular pressure waveform is a direct reflection of hemodynamics. Evaluating this waveform may provide an additional opportunity for screening subjects for cardiovascular anomalies and arrhythmias.
AN UNUSUAL OCULAR INJURY OLLOWING FACIAL TRAUMA: A CASE REPORT. A. O. Fasola,A.E. Obiechina, *M. O. Obajinmi, **C.O. Bekibele. Departments of Oral and Maxillofacial Surgery, Radiology* and Ophthalmology“, College of Medicine,. University College Hospital, P. M. B. 5116, Ibadan. Nigeria. ABSTRACT.
Objective: To determine the pattern of ocular disorders among computer users in Enugu. Methods: A cross-sectional survey of computer users was conducted in Enugu metropolis between August and December 2000. 560 subjects were selected by simple random sampling method. Examination methods include use of ...
Background: In black Africa, the severity of traumatic ocular emergencies (TOE) is increased by a lack of ophthalmologists and often inadequate or even the inexistence of surgical ... These TOE were: corneoscleral rupture (63.2%), vitreoretinal iron foreign body (16.8%), retinal detachment (15%), and macula hole (5%).
The parents who were immediately alerted brought the child to our facility. There was history of bleeding which could not be estimated. There was no loss of consciousness, however. No history of previous ocular trauma, use of glasses or eye surgery. Examination showed equal visual acuity (VA) of at least 6/60 in each eye.
Eleonora M. Lad
Conclusions and importance: To our knowledge, this is the first report of ophthalmological and ocular pathology observations in an EEE patient. Interestingly, the inflammatory findings in the retina are reminiscent of the central nervous system effects of EEE virus. These findings are relevant given the recent epidemic of microcephaly and ophthalmic complications secondary to another arboviral virus, the Zika virus.
Conclusion: Diabetic patients' knowledge on diabetes mellitus and its ocular manifestations, and the attitude of diabetic patients towards eye examination were poor. Intensive health education by diabetes care givers and leaders of the Ghana Diabetic Association for diabetic patient is therefore required to improve attitude ...
Groen, Eric; Bos, Jelte E.; Nacken, Peter F M; De Graaf, Bernd
A new, automatic method for determination of human ocular torsion (OT) was developed based on the tracking of iris patterns in digitized video images. Instead of quantifying OT by means of cross-correlation of circular iris samples, a procedure commonly applied, this new method automatically selects
Groen, E.L.; Bos, J.E.; Nacken, P.F.M.; Graaf, B. de
A new, automatic method for determination of human ocular torsion (OT) was devel-oped based on the tracking of iris patterns in digitized video images. Instead of quanti-fying OT by means of cross-correlation of circular iris samples, a procedure commonly applied, this new method automatically
ABSTRACT. OBJECTIVE: The aim of the study was to analyse the ocular diseases that were seen at the an outreach post. Patients and Methods: Data on 883 patients was collected from records of patients starting from J anuary 2005 to August. 2005 at the Saminaka outreach eye clinic. Information on age, sex occupation ...
Sangwan, Virender S; Jain, Rajat; Basu, Sayan; Bagadi, Anupam B; Sureka, Shraddha; Mariappan, Indumathi; MacNeil, Sheila
It has only been a quarter of a century since the discovery of adult stem cells at the human corneo-scleral limbus. These limbal stem cells are responsible for generating a constant and unending supply of corneal epithelial cells throughout life, thus maintaining a stable and uniformly refractive corneal surface. Establishing this hitherto unknown association between ocular surface disease and limbal dysfunction helped usher in therapeutic approaches that successfully addressed blinding conditions such as ocular burns, which were previously considered incurable. Subsequent advances in ocular surface biology through basic science research have translated into innovations that have made the surgical technique of limbal stem cell transplantation simpler and more predictable. This review recapitulates the basic biology of the limbus and the rationale and principles of limbal stem cell transplantation in ocular surface disease. An evidence-based algorithm is presented, which is tailored to clinical considerations such as laterality of affliction, severity of limbal damage and concurrent need for other procedures. Additionally, novel findings in the form of factors influencing the survival and function of limbal stem cells after transplantation and the possibility of substituting limbal cells with epithelial stem cells of other lineages is also discussed. Finally this review focuses on the future directions in which both basic science and clinical research in this field is headed. PMID:24492499
Osborn, Katherine L; Hettler, Debbie
The purpose of this study was to determine if there is a consistent set of recommendations for patients who wear an ocular prosthesis or if each patient needs an individual plan. A self-report questionnaire was distributed to members of the American Society of Ocularists. The survey consisted of 4 questions regarding frequency of removal and cleaning and preferred cleaning and lubrication agents. Respondents had 4 weeks to return the survey for results to be included. One hundred three surveys were sent; 8 were undeliverable, leaving a sample size of 95. Thirty-four percent (32 ocularists) responded. The reason with the most frequency for prosthesis removal was only when the prosthesis felt irritated (31%). Fifty-eight percent reported that the ocular prosthesis should be cleaned every time it is removed. Mild soap or baby shampoo was listed as the preferred cleaning agent with 24% each. A majority listed a silicone oil-based lubricant (29%), but responses varied based on the patient's needs. An individualized treatment plan is indicated for most patients who wear an ocular prosthesis. Despite this, some commonalities in responses were noted, specifically that the ocular prosthesis needs to be cleaned with every removal, and a silicone oil lubricant is recommended. Copyright (c) 2010 American Optometric Association. All rights reserved.
... engagement is still common at the UHB. This has the effect of delaying or not realising the lumbar puncture which is the basis for the diagnosis of meningitis, increasing the morality associated with this serious disease. Do not make a lumbar puncture pending ocular fundus is a medical error that can be fatal for the patient.
Dec 13, 2016 ... biometry for calculation of optical power of artificial lens implants is another advantage .... Loss of vision. 8. 8. Photopsia. 3. 3. Bangal, et al.: Pattern of ocular pathologies diagnosed with B-scan ultrasonography. Nigerian Journal of Ophthalmology ¦ Jul-Dec 2016 ¦ Volume 24 ¦ Issue 2. 73. [Downloaded free ...
Jul 26, 2017 ... it, and adnexal structures, which support it both within the orbit and external to the orbit. The distance ... orbito-ocular disease, referred for MRI of the brain and/or paranasal sinuses. The referring clinician ... In addition, the difference observed in the length of the IZL among the various age groups was not ...
The spectrum of ocular diseases in HIV-infected patients in developing countries is .... Vernal conjunctivitis 1 (0.8). Sub conjucnctival ... of HIV infection. In this study, it was also 'found to be an important cause of unilateral blindness due to severe involvement of the eyes, late presentation of patients and failure of early ...
Extramedullary plasmacytoma can affect practically all the systems in the body including the eyes, nervous system, head and neck, respiratory system, breast, gastrointestinal system, urogenital system and lymph nodes. These systemic manifestations are reviewed. Key words: Plasmacytoma, ocular, outcome, neurological, ...
Every health worker, particularly ophthalmologists, should be familiar with the ocular complications of leprosy. 2. Periodic screening and surgical outreach programmes by ophthalmologists should be integrated into leprosy care programmes with a view to treating avoidable causes of blindness, especially cataract, uveitis, ...
Context: B-scan ultrasonography (USG) plays a key role as a valuable diagnostic imaging device in the field of ophthalmology. Aim: To study the pattern of ocular pathologies defined by B-scan USG in rural hospital. Settings and Design: Hospital-based prospective observational study. Materials and Methods: ...
Ocular injuries and eye care seeking patterns following injuries among cocoa farmers in Ghana. Boadi-Kusi Samuel Bert1,2, Hansraj Rekha1, Mashige Khathutshelo Percy1. 1. Discipline of Optometry, School of Health Sciences, University of KwaZulu-Natal, Durban 4000,. South Africa. Private Bag X54001. 2. Department of ...
Full Text Available PURPOSE: To evaluate and compare a stereo-biomicroscopic technique of ocular torsion measurement with fundus photographic technique. METHODS: This prospective masked observational study included 72 eyes of 36 consecutive subjects with normal ocular motility. The disc-foveal angle was measured by two masked investigators using a slitlamp stereo-biomicroscopic and fundus photographic technique. RESULTS: The mean age was 13.7 years (6 - 44 years, and 15 (41.6% were males. The average torsion using the slitlamp technique was 5.5 3.3o and 6.1 4.3o with fundus photographic technique. Clinical agreement between the two techniques for 5o and 6o torsion was 81% and 90% respectively. The average difference between the two techniques was 3.0 2.6o. The mean inter-ocular difference was 3.3 2.7o (SD, 2.77 and 5.5 4.6o using the slitlamp and fundus photographic technique respectively. The Pearson correlation coefficient (r2 was 0.5 CONCLUSION: The fundus photographic technique remains the gold standard test for the measurement of ocular torsion. The slitlamp biomicroscopic method can be useful where a fundus camera is unavailable. Further studies are required to test the repeatability of these tests.
Norel, J. van
This thesis investigates the accumulation of fluid in the yellow spot (macular edema) in ocular inflammation (uveitis). Macular edema may result in definitive loss of vision.Two methods of imaging of macular edema are fluorescein angiography (FA) and optical coherence tomography (OCT). The first
also to family physicians and to pediatricians who probably represent the ideal educators for children and their parents. This article reports summary of circumstances, ophthalmic intervention, and therapeutic outcome of an unusual case of retained ocular adnexal foreign body (FB) in a pediatric patient. CASE REPORT.
Dec 13, 2016 ... carcinoma, especially among young patients, should be kept in mind. The outcome of management is better, with possible cure, if diagnosis is made early and proper surgery along with other adjuvant measures are undertaken. Keywords: Epidemiological study, periocular malignancies, primary ocular ...