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Biomedical subjects

D A Hiles

Publications and source records attributed to D A Hiles.

At least 37 records · Page 2Linked to original sources
PubMed1985

Solitary eosinophilic granuloma of the lateral orbital wall.

Two children (aged 18 and 23 months at the initial examinations) were each ultimately found at surgery to have a solitary eosinophilic granuloma of the lateral orbital wall. Both patients had a symptomatic period of six weeks during which time other diagnoses were considered: bacterial preseptal cellulitis and mumps dacryoadenitis in the first case and traumatic recurrent orbital hematoma in the second. Diagnostic difficulties stemmed from confusing features in their histories, as well as the location of the lesion and the deceptively minimal swelling relative to the actual size of the lesion. Follow-up ten and 18 months after curettage of the two lesions showed no recurrence or evidence of systemic involvement. Although most reported cases describe the orbital frontal bone as the site of origin in the orbit, our cases demonstrated that unifocal eosinophilic granuloma may occur in the lateral wall of the orbit.

Diagnosis, Differential↗
PubMed1984

Congenital superior oblique palsy in infants.

A retrospective review of 20 cases of infants with congenital superior oblique palsy showed that all cases had been diagnosed and treated surgically before the patient was 2 years old. Single inferior oblique weakening procedures, single superior oblique tucks, and combined inferior oblique weakening procedures and superior oblique tucks were performed as the initial surgical procedures. Best results were obtained with the two-muscle procedure. The presence of preoperative primary position hypertropia correlated significantly with failure of single inferior oblique weakening to eliminate the signs of superior oblique palsy.

Evaluation Studies as Topic↗
PubMed1984

Intraocular lens implantation in children with monocular cataracts. 1974-1983.

Two hundred twenty-five consecutive intraocular lens (IOL) implants performed by the same surgeon from 1977 to 1983 are reviewed. Ninety (40%) patients had traumatic cataracts and 135 (60%) patients had infantile cataracts. Fifty-four percent of the patients presented with preoperative complications. The most frequent were corneal scars (62%) in the traumatic cataract patients, and posterior lenticonus (18%), microphthalmia (16%), PHPV (14%), and optic nerve defects (12%) in the infantile cataract patients. The iris suture lens was implanted from 1973 to 1982, but the posterior chamber lens is now the most frequently implanted primary IOL. Flexible anterior chamber or iris suture IOLs are used as secondary implants. Follow-up ranged from six months to nine years. Postoperatively, 66% of the patients required spectacles for residual optical correction and 55% required occlusion for amblyopia. Postoperative complications consisted of post-pseudophakos membranes (13%), peripheral iris erosion (13%), iris sphincter erosion (18%), dislocated IOLs (7%) and corneal edema (4%). Secondary surgical procedures relating to the IOL were discissions of post-pseudophakos membranes (6 patients), refixation of dislocated lens (15 patients) and IOL removal (6 patients). The best corrected visual acuities during the course of the follow-up was 20/20 to 20/40 in 34% of the patients, 20/50 to 20/100 in 21%, 20/200 in 12%, and less than 20/200 in 33% of patients. Sixty percent of the traumatic cataract patients achieved 20/20 to 20/40 acuity and 17% of the infantile cataract patients achieved this level. Primary implantation patients achieved superior acuities over secondary implantations in both groups.

Cataract↗
PubMed1983

Treatment of ragweed allergic conjunctivitis with cromolyn sodium 4% ophthalmic solution.

We treated 31 patients with ragweed conjunctivitis in an eight-week, double-masked parallel-group study with cromolyn sodium 4% ophthalmic solution. Analysis of data showed preseason serum IgE antibody to ragweed level was a significant predictor of drug response. Of 16 patients with ragweed IgE values of less than 100 ng/ml, the nine treated with cromolyn had significantly fewer symptoms during the course of treatment than the seven in the placebo group. Of the 15 remaining patients, who had IgE levels of more than 100 ng/ml, the eight treated with cromolyn improved but the difference between their symptom scores and those of the seven patients treated with placebo was not statistically significant.

Adolescent↗
PubMed1983

Infantile cataracts.

Explore the source record for details and available documents.

Aphakia, Postcataract↗
PubMed1982

A histopathologic study of bilateral aphakia with a unilateral intraocular lens in a child.

A 7-year-old boy who had had electrically induced cataracts since he was 6 months old underwent a lens extraction by phacoemulsification in his right eye. He later refused to wear a contact lens. When the boy was 10 year old, the lens of his left eye was removed by phacoemulsification and an intraocular lens was implanted. The intraocular lens functioned well and was tolerated by the boy until he died in an automobile accident at the age of 16 years. A histopathologic study of the eyes, which were obtained post mortem, showed a decreased corneal endothelial cell population, mild focal atrophy of iris structures, and mild lymphocytic infiltration in the implanted eye. Vitreous liquefaction and epiretinal membrane formation occurred in both eyes.

Adolescent↗
PubMed1981

Posterior fixation suture operation (fadenoperation).

The posterior fixation operation affords the ophthalmologist an additional procedure for the correction of DVD, nystagmus blockage syndrome and abnormal distance/near relationships associated with esodeviations. The authors report that 95% of the patients had improved their control of manifest DVD. The results of surgery for the nystagmus blockage syndrome and abnormal distance/near relationship patients remain inconclusive. The posterior fixation procedure, while technically difficult, may be performed safely by the experienced surgeon. Refinements of the surgical technique are described.

Adolescent↗
PubMed1980

Structural features of extraocular muscles of children with strabismus.

Ninety extraocular muscle (EOM) biopsy specimens from 80 children with strabismus and normal ocular alignment were studied by light microscopy, enzyme histochemistry, and electron microscopy. Light microscopy showed considerable variation in muscle fiber shape and size with sarcomere disruption, sharp increases in endomysial and perimysial collagen, numerous vacuoles and subsarcolemmal inclusions. Electron microscopy showed disruption of myofilaments, nemaline rods, abnormal mitochondria, leptomeric profiles, occasional "myelin figures," glycogen, and lipid-like droplets. Some intramuscular nerves contained long-spacing collagen ("Luse bodies"). Unlike somatic skeletal muscle, EOM showed a consistent lack of mosaic pattern and reciprocal stain activity between fiber types noted by enzyme histochemistry. Quantitative observations indicate that minimal but consistent morphologic differences exist between strabismic and nonstrabismic EOM. The role these changes play in the pathogenesis of strabismus and their significance remains unclear.

Adenosine Triphosphatases↗
PubMed1980

Characteristics of infantile esotropia following early bimedial rectus recession.

A homogeneous group of infantile esotropes were studied who underwent surgical alignment before 1 year of age. Three groups emerged: those who remained stable following their initial early alignment, those who were well aligned and remained stable for prolonged periods of time and then decompensated, and those who were unstable throughout the observation period. Preoperatively, no factors were identified that predicted into which group each patient might enter. Other associated factors were identified that affected the strabismic angle and these were overactions of the inferior oblique muscles, dissociative vertical deviation, rotary and other forms of nystagmus, amblyopia, and changing refractive errors. The treatment modalities consisted of miotics, glasses, bifocals, occlusion, and repeated operations. This study underscores the instability of the conditions of patients with infantile esotropia and the need for repeated observations throughout the first decade of life.

Amblyopia↗
PubMed1980

The role of the crystalline lens epithelium in postpseudophakos membrane formation.

Pupillary membranes were experimentally produced in rabbits and correlated with biopsy specimens from human eyes which had undergone extracapsular cataract extraction. These fibrous membranes were derived from proliferation of lens epithelial cells. Wider anterior capsulectomies or barrier devices attached to intraocular lenses may reduce opacification of intact posterior capsules.

Adult↗
PubMed1980

Visual acuities of monocular IOL and non-IOL aphakic children.

The vision of 341 monocular aphakic children was corrected with contact lens, intraocular lens, or spectacles and the visual results of each series were compared. The acquired and infantile contact lens and IOL cataract patients achieved similar levels of aphakic visual acuities. Seventy percent of the IOL and 64% of the contact lens-acquired cataract patients achieved 20/20 to 20/40, while 22% of the IOL and 16% of the contact lens infantile cataract patients also reached this level. Twenty patients wore monocular spectacles and none achieved adequate levels of visual rehabilitation. Forty-six patients were unable to wear or did not receive aphakic correction because of patient or parental refusal or ocular pathologic contraindications.

Aphakia, Postcataract↗