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Biomedical subjects

C G Summers

Publications and source records attributed to C G Summers.

At least 55 records · Page 3Linked to original sources

Paroxysmal facial itch: a presenting sign of childhood brainstem glioma.

Two children with neurofibromatosis and a chief complaint of severe, episodic, unilateral facial itching were found to have brainstem glioma. Initial computerized tomography of the brain was thought to be normal, but the brainstem tumor was subsequently demonstrated on magnetic resonance imaging. The paroxysmal facial itching resolved in both cases after a course of radiation therapy. The pathophysiology of the attacks of facial itching is unknown but must be related to the brainstem glioma. This is the first report of paroxysmal, unilateral facial itching as a presenting sign of childhood brainstem tumor.

Brain Neoplasms↗

Albinism.

Genetic abnormalities of the melanin pigment system in which the synthesis of melanin is reduced or absent are called albinism. The reduction in melanin synthesis can involve the skin, hair follicle, and eye, resulting in oculocutaneous albinism, or can be localized primarily to the eye, resulting in ocular albinism. Approximately 1 in 17,000 individuals in the United States has oculocutaneous albinism, and more than 1 per cent of the population are heterozygous for a gene producing albinism.

Albinism↗

Use of a modified binocular visual field to assess cyclodiplopia.

The patient who notes binocular diplopia may indicate that horizontal, vertical, or cyclorotary components are present. Although the single binocular visual field provides an indication of the area which is free of horizontal and vertical diplopia, it does not assess cyclorotary diplopia. A simple modification of the single binocular visual field which allows determination of the clinical significance of the cyclorotary component of diplopia is presented. Reproducible information is easily obtained, assisting in patient follow-up and management.

Adolescent↗

Argon laser treatment of periocular lesions: an experimental study.

Argon laser photocoagulation is a promising alternative in the treatment of vascular lesions of the lid and periocular tissues. Experimental argon laser treatment of feline ocular and oral mucosa was undertaken to identify a protective shield that was satisfactory in preventing ocular damage and to identify a power that would be effective but avoid significant side effects.

Animals↗

Juvenile iridoschisis and microphthalmos.

Spontaneous iridoschisis and corneal edema developed in the microphthalmic eye of an 8-year-old. There was no history of trauma, inflammation, or congenital iris abnormality.

Cell Count↗

Secondary IOL power calculations: a comparison of regression formula and refraction method in accurate prediction of emmetropia.

A retrospective review of 51 secondary intraocular lens (IOL) implantations was made to determine the relative accuracy of the SRK regression formula and the refraction method described by Holladay in preoperative prediction of emmetropic IOL power. The regression formula accurately predicted emmetropia within 1 diopter (D) in 63% of patients; the refraction method accurately predicted within 1 D in only 26% of cases. The emmetropic power predicted by the two formulas differed by at least 1 D in 76% of patients. Precise measurement of preoperative variables is imperative to ensure accurate prediction of emmetropic IOL power in the patient considered for secondary implantation.

Aphakia↗

Ghost cell glaucoma following lens implantation.

When intraocular hemorrhage occurs following cataract surgery and lens implantation, ghost cell glaucoma may develop. An intraocular lens (IOL) may be a factor in recurrent bleeding, particularly in the predisposed patient. Six patients with ghost cell glaucoma following cataract surgery and lens implantation are described. Because intraocular pressure (IOP) was uncontrolled, vitrectomy was performed to remove the reservoir of ghost cells. In each case, postoperative visual acuity improved to 20/40 or better and IOP was controlled with the use of medications.

Aged↗

The brain stem in sudden infant death syndrome. A postmortem survey.

Abnormal central neural regulation of respiration may be involved in the pathogenesis of the sudden infant death syndrome (SIDS). A retrospective investigation of brain-stem morphology in 34 SIDS victims compared to well-matched controls revealed medullary gliosis in the reticular formation in 12% and a single microglial nodule suggestive of a viral infection in one infant. These findings support the need for more extensive prospective neuropathological investigations in SIDS utilizing more sophisticated techniques.

Autopsy↗

Vision despite tomographic absence of the occipital cortex.

A 14-month-old boy with developmental delay showed microcephaly, spastic diplegia, central visual fixation and an esotropia. A head tomographic scan disclosed absence of normal occipital cortex and electroencephalography showed markedly reduced voltages over the occipital region. Visual development in this patient may be related to heterotopic occipital cortex of a functioning non-striate system of visual processing. Visual function cannot be predicted when severe developmental anomalies of the occipital cortex are detected with computerized tomography.

Abnormalities, Multiple↗

Ocular ischemic syndrome in a child with moyamoya disease and neurofibromatosis.

Ocular ischemic syndrome is extremely rare in childhood. Patients with moyamoya disease may be particularly susceptible to the development of ocular ischemia due to the associated carotid occlusion. A 19-month-old boy presented with neurofibromatosis and signs of ocular ischemia. At 29 months of age, he developed dense right vitreous hemorrhage and eventually lost vision in that eye due to phthisis. At almost six years of age, he developed an acute hemiplegia and was then diagnosed with moyamoya disease. This rare instance of childhood ocular ischemia in conjunction with moyamoya disease and neurofibromatosis demonstrates the serious ocular and systemic sequelae of occlusive vascular disease.

Arterial Occlusive Diseases↗

Ocular motor apraxia associated with intracranial lipoma.

Congenital ocular motor apraxia is rarely associated with brain tumors. A 10-month-old girl with normal vertical eye movements and head thrusting to initiate horizontal saccades is presented. CT brain scan revealed a midline posterior fossa mass and histopathology confirmed the clinical diagnosis of lipoma. Unlike previously described cases of posterior fossa brain tumors associated with congenital ocular motor apraxia, this patient showed persistent ocular motor apraxia despite complete resection of the tumor.

Apraxias↗

Subconjunctival steroid in the management of uveal juvenile xanthogranuloma: a case report.

Uveal juvenile xanthogranuloma (JXG) is a rare intraocular tumor which usually occurs in very young children. Most reported cases of successfully treated uveal juvenile xanthogranuloma have received systemic steroids, irradiation or excision. Some cases have responded to topical steroids alone. We report a case of JXG with recurrent hyphemas and elevated intraocular pressures despite the use of topical steroid. This patient responded to the addition of subconjunctival steroid injection. This is the first report to our knowledge demonstrating a response to periocular steroid supplementation for uveal JXG unresponsive to topical steroids.

Betamethasone↗

Unexpected good results after therapy for anisometropic amblyopia associated with unilateral peripapillary myelinated nerve fibers.

Unilateral extensive myelination of the peripapillary nerve fibers may be associated with anisometropic myopia, strabismus, and reduced vision. Despite aggressive occlusion of the normal eye, visual results are often disappointing, presumably due to associated structural abnormalities in the macula which limit visual potential. We report two cases, a 21-month-old child and a 23-month-old child with unilateral peripapillary myelination, ipsilateral high myopia, and dense amblyopia. Despite an abnormal macular reflex in each child, vision improved to 20/30 in one child and 20/50 in the other child after occlusion therapy. Visual results in these patients suggest that aggressive amblyopia therapy should be considered in patients with anisometropic amblyopia associated with extensive myelination continuous with the optic nerve. Not all patients with unilateral peripapillary myelinated nerve fibers, an abnormal macula, and myopia will have refractory amblyopia.

Amblyopia↗

Neodymium:YAG pupilloplasty in pediatric aphakia.

An adequate pupillary aperture is required for accurate ophthalmoscopy and retinoscopy in pediatric aphakia. When pupillary miosis does not respond to pharmacologic dilation, optical iridectomy performed with a vitreous suction-cutting instrument under general anesthesia may be required. We report a 27-month-old aphakic child whose pupillary aperture was enlarged from 1 mm to 3.5 mm with neodymium (Nd):YAG pupilloplasty, following intramuscular sedation with meperidine, promethazine, and chlorpromazine. Removal of the laser chin rest and positioning of the patient on a table with adjustable height facilitated delivery of 140 applications at 2.5 to 4.3 mJ to the pupillary border. Levobunolol 0.5% controlled the transient posttreatment rise in intraocular pressure. We suggest that Nd:YAG pupilloplasty performed with sedation be considered as an alternative to intraocular surgery when pupillary miosis in pediatric aphakia does not respond to dilating agents.

Aphakia↗

Is the phakic eye normal in monocular pediatric aphakia?

This retrospective review of 97 pediatric patients who underwent monocular surgery for congenital or developmental cataracts studied the incidence of abnormalities in the contralateral phakic eye. Fifty-nine percent of patients had a normal phakic eye. However, 40 patients showed at least one abnormality in the phakic eye: reduced vision (21%), nystagmus (19%), cataract (15%), iris heterochromia (9%), myopia (6%), microphthalmos (6%), pupillary miosis (2%), congenital glaucoma (2%), optic nerve abnormality (2%), aniridia (1%), and corneal opacity (1%). Not all abnormalities were detected at the time of diagnosis of the contralateral cataract. The more significant findings of reduced vision and nystagmus in the phakic eye were usually detected postoperatively, often several months after the optimum time for treatment of pediatric cataracts. We suggest that monocular cataract surgery not be delayed. This will allow the best vision to be obtained for the aphakic eye, as the "sound eye" may not always be normal in monocular pediatric aphakia.

Aphakia, Postcataract↗