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Biomedical subjects

E S Perkins

Publications and source records attributed to E S Perkins.

At least 19 recordsLinked to original sources
PubMed1992

Cross reactivity between Klebsiella pneumoniae and ocular tissue.

Klebsiella pneumoniae has been implicated as a possible aetiological agent in ankylosing spondylitis and acute anterior uveitis. Cross-reactivity between antigens of klebsiella and bovine vitreous has been reported. In the present study sera from rabbits immunised with Klebsiella pneumoniae was tested against fresh guinea pig and human ocular tissues using immunodiffusion and immunofluorescent methods. No cross-reactivity between klebsiella and the ocular tissues used could be demonstrated by these techniques.

Animals↗
PubMed1990

Argon laser panretinal photocoagulation in ischemic central retinal vein occlusion. A 10-year prospective study.

We conducted a prospective, planned study of argon laser panretinal photocoagulation (PRP) in ischemic central retinal vein occlusion (CRVO) over a 10-year period in 123 eyes. On comparing the lasered eyes versus the nonlasered eyes, there was no statistically significant difference between the two groups in the incidence of development of angle neovascularization (NV), neovascular glaucoma (NVG), retinal and/or optic disc NV, or vitreous hemorrhage, or in visual acuity. Our study, however, did show a statistically significant (P = 0.04) difference in the incidence of iris NV between the two groups, with iris NV less prevalent in the laser group than in the nonlaser group, but only when the PRP was performed within 90 days after the onset of CRVO. The other parameter which showed a statistically significant difference between the two groups was the peripheral visual fields-the laser group suffered a significantly (P less than or equal to 0.03) greater loss than the non-laser group. We discuss the implications of these findings in light of the natural history of ischemic CRVO and of ocular NV. Since the original rationale for advocating PRP in ischemic CRVO was the proven beneficial effect of PRP on ocular NV in proliferative diabetic retinopathy, we also discuss the disparities in the disease process between ischemic CRVO and proliferative diabetic retinopathy and in their responses to PRP.

Aged↗
PubMed1989

Sunlight, skin sensitivity, and senile cataract.

This study explores the association between sunlight exposure and senile cataract, taking into account such individual differences as skin sensitivity to sunlight and the use of sun-shielding devices, i.e., sunglasses and hats. A case-control study was conducted among 160 matched pairs of subjects between October 1, 1984 and June 1, 1985 at the University of Iowa Hospitals and Clinics in Iowa City, Iowa. Cases were selected from among all patients admitted for inpatient or outpatient cataract surgery who were at least 40 years old. Controls were selected from among those waiting for a friend or relative who was attending one of the ophthalmology clinics. Controls were matched to the cases on a 1:1 basis on sex and age (+/- one year). No association was observed between history of sunlight exposure and senile cataract. However, independent of sunlight exposure, the cases with nuclear cataracts reported a more severe acute skin response upon exposure to sunlight for the first time in the summer (a severe burn with blistering) than did their age- and sex-matched controls (McNemar odds ratio (OR) = 1.73, 95% confidence interval (CI): 1.03-2.91). In addition, independent of sunlight exposure, the male controls reported a greater average lifetime use of head coverings in summer which shaded their eyes from the sun than did their age- and sex-matched cases (McNemar OR = 0.48, 95% CI: 0.25-0.94).

Adult↗
PubMed1988

Depth measurement with the slit-lamp microscope.

The sagittal distance of ocular structures can be obtained with a slit-lamp microscope providing the movement of the slit-lamp can be measured. A simple device consisting of a pointer attached by a spring clip to the axle of a Haag-Streit 900 slit-lamp is described. The pointer rides over a scale which slides with the slit-lamp. Comparisons of anterior chamber depth and lens thickness showed a high correlation between this optical method and ultrasound measurements.

Anterior Chamber↗
PubMed1988

Lens thickness in early cataract.

The search for environmental factors associated with cataract has produced conflicting evidence and one possible reason may be that environmental influences are initiating events occurring perhaps for short periods many years before loss of sight from cataract. It is important, therefore, to be able to detect the earliest changes of cataract formation so that epidemiological studies have a better chance of detecting environmental factors. Two possible indicators of early cataract are delayed growth of the lens and abnormalities of the anterior subcapsular clear zone of the lens as observed on slit-lamp microscopy. A series of patients with early lens changes was compared with control subjects in respect to these two factors. Lens thickness was measured by a simple optical method. The mean thicknesses of the lens in patients with early cortical or posterior subcapsular lens changes were significantly less than that of age matched controls. 60% of lenses with early cataract of all types were found to have a deficient or absent anterior subcapsular clear zone. Lens thickness and the appearance of the anterior subcapsular clear zone are easy to measure and observe through an undilated pupil. Although the prognostic value of the results is uncertain in individual cases owing to the rather wide scatter of results in normal eyes, such observations could be of value in comparative studies of populations.

Adolescent↗
PubMed1987

The elderly at home: service needs and provision.

This paper arises from research to develop a profile of the elderly living in the community. Data are presented from interviews with a stratified random sample of 1406 elderly people living in the Trafford area of Greater Manchester. The findings suggest that in reality community care for the elderly means care by lay carers. Assistance with all tasks ranging from intensely personal care, for example bathing and dressing, to the practical household tasks, such as cooking and cleaning, was more often provided to the elderly by spouses and daughters/daughters-in-law than by the statutory services.It is suggested that some form of eligibility criteria may be used either consciously or unconsciously by general practitioners and other health care workers when referring elderly people to the nursing and social services which may mean that the statutory services do not complement the care given by lay carers. Furthermore, the presence of a lay carer may prevent the situation coming to the attention of the primary health care team.

Aged↗
PubMed1985

Family studies in glaucoma.

Two groups of patients with a family history of chronic open-angle glaucoma were compared with a normal population of 5919 individuals studied during the Bedford Glaucoma Survey. The mean screening intraocular pressure was significantly raised in both groups with a family history of chronic open-angle glaucoma. The prevalence rate of a raised intraocular pressure was 3.81 times that found in the normal population. This relationship was maintained when age-dependent prevalence rates were evaluated. No correlation between raised intraocular pressure and type of familial involvement could be determined. A 10- to 12-year follow-up of one group with a family history for open-angle glaucoma (101 patients) showed that 3% developed confirmed glaucoma, while an additional 5.9% were diagnosed as suspected chronic open-angle glaucoma. A letter survey of this group showed that 9 out of 63 respondents knew of additional family members who developed glaucoma over this 10-12-year period.

Adult↗
PubMed1985

The ocular pulse and intraocular pressure as a screening test for carotid artery stenosis.

The ocular pulse and applanation tension were measured with a recording applanation tonometer in 38 patients suspected of having internal carotid artery stenosis. Abnormalities of the ocular pulse amplitude, intraocular pressure, or combinations of these two measurements were found in 23 (82%) of 28 patients who were subsequently found to have angiographic evidence of 50% or more stenosis of one or both internal carotid arteries. Of 10 patients without angiographic evidence of carotid stenosis the ocular pulse amplitude, intraocular pressure, or both were abnormal in five, but two patients had an ocular cause for abnormality and two of the remaining three had evidence of carotid disease in the form of atheromatous plaques. These results suggest that measurement of the amplitude of the ocular pulse in addition to the intraocular pressure can predict the presence of carotid artery stenosis and indicate the need for further investigation. If a tonometer capable of measuring the pulse amplitude was used routinely in ophthalmic examinations, it would provide a useful screening test for the early diagnosis and treatment of carotid artery disease and might thereby reduce the frequency of strokes.

Arterial Occlusive Diseases↗
PubMed1985

The association between pinguecula, sunlight and cataract.

The pathology and epidemiology of pinguecula suggest that it is due to exposure to sunlight. There is some epidemiological and laboratory evidence that sunlight is an etiological factor in cataract so that it would be expected that the two conditions--pinguecula and cataract--would occur together more frequently than by chance. In a series of patients requiring cataract extraction pinguecula did not occur more frequently than in sex- and and aged-matched controls. Although there was a correlation between an outdoor working environment and the incidence of pinguecula there was no such correlation with cataract. It is concluded that direct exposure of the eye to sunlight did not seem to be a factor in the development of age-related cataract in this population.

Aged↗
PubMed1984

[Ocular pulse curve in glaucoma without hypertension].

The ocular pulse amplitudes were measured with a recording applanation tonometer in eyes of patients with primary open-angle glaucoma, low-tension glaucoma and in normal subjects. The mean ocular pulse amplitude of 62 eyes of 31 patients with low-tension glaucoma did not differ significantly from that of normal eyes, but there were more eyes with low and high pulse amplitudes than would be expected in a normal population. These results suggest that the patients with low-tension glaucoma did not comprise a homogeneous population, but contained one group of patients with evidence of reduced choroidal blood flow and another group with pulse amplitudes similar to those found in primary open-angle glaucoma.

Glaucoma↗
PubMed1984

Cataract: refractive error, diabetes, and morphology.

A retrospective analysis of 388 records of patients undergoing surgery for cataract between the years 1968 and 1978 showed that more women than men were admitted. About 13.7% of the patients were diabetic, and there was a striking excess of women over men with diabetes and cataract. The diabetic patients required surgery at an earlier age than the non-diabetics. Patients who had been refracted at least 5 years before surgery showed an incidence of myopia of -1.00 D or more of 25.4%. In 34% of the whole series the aphakic refraction was less than +11.00 D, again suggesting that myopes are more likely to develop a cataract than non-myopes. Posterior subcapsular lens changes alone or in combination with nuclear or cortical opacities were present in over 40% of all patients and the mean age of patients with this type of change alone was significantly lower than patients with predominantly nuclear or cortical changes. Posterior subcapsular opacities seem to be more common in Iowa than in England or India. The morphological similarity of this type of lens change with known types of secondary cataract suggests that it is not entirely a senile change but may be due to environmental or dietetic factors.

Aged↗
PubMed1984

Uveitis in London and Iowa.

The pattern of uveitis seen in a caucasian population in Iowa was found to be very similar to that seen in London in spite of geographical and climatic differences in the two locations. Acute anterior uveitis was the commonest type of uveitis but fewer of the Iowa patients showed radiological evidence of ankylosing spondylitis or Reiter's syndrome. Toxoplasmosis was responsible for 9% of cases in both series. It is concluded that genetic factors are more important than geographic location in determining the types of uveitis which occur in a caucasian population.

Female↗
PubMed1984

Survey of ophthalmic conditions in a Labrador community: II. Ocular disease.

An ophthalmic examination of 87% of the resident population of Nain, Labrador (latitude 56 degrees 33'N) was carried out, and the findings in 330 Inuit, 236 persons of mixed racial ancestry (Inuit-Caucasian) and 80 Caucasians were analysed. Legal blindness was present in 1.2% of the survey population, compared with 1.6% of the study population of the Arctic Ophthalmological Survey of 1970-71. Of the age group 52 to 85 years, 10.8% were legally blind, compared with 0.6% of the same age group surveyed in the Framingham (Massachusetts) Eye Study. The leading causes of unilateral or bilateral blindness in Nain were trauma, especially in the Inuit, and spheroidal degeneration (Labrador keratopathy); neither senile macular degeneration nor diabetic retinopathy had caused legal blindness. External diseases, particularly spheroidal degeneration (which affected 19% of the population), phlyctenular keratoconjunctivitis and epiblepharon, were the commonest diagnoses in Nain. No diabetic retinopathy was detected, but evidence of toxoplasmosis was encountered. Compared with the study population of the Arctic Ophthalmological Survey, the Nain population had a higher prevalence of spheroidal degeneration and other corneal diseases.

Adolescent↗
PubMed1982

Open angle glaucoma, ocular hypertension, low-tension glaucoma, and refraction.

An analysis of the refractions of patients with primary open angle glaucoma, ocular hypertension (OH), and low-tension glaucoma showed that myopia occurred more frequently in each group than would be expected in a normal population of similar age. One in three of the myopes with OH had glaucomatous field defects on follow-up examination, whereas the defects developed in only one in 20 of the emmetropes and in one in 40 of the hypermetropes. These results suggest that myopic eyes are more susceptible to the effects of raised intraocular pressure than are nonmyopic eyes and that myopes with OH have a particularly high risk of the development of field defects.

Adolescent↗
PubMed1982

Intraocular inflammatory disorders: uveitis.

Emphasis on the association between intraocular inflammatory disorders and systemic disease guides the clinical descriptions of acute and chronic uveitis in this article. Practical information on establishing the diagnosis and treating the condition is provided.

Acute Disease↗
PubMed1981

Hereditary and congenital factors in inflammations of the uveal tract.

The discovery of associations between HLA antigens and particular diseases has provided an explanation for some racial differences in the incidence of uveitis. Acute anterior uveitis is strongly associated with HLA B27 and this hereditary influence has been substantiated by evidence of familial cases. HLA B5 occurs more frequently in Japanese patients with Behçet's disease and HLA BW22J and HLA DWa are associated with the Vogt-Koyanagi-Harada disease. HLA B7 and HLA DRW2 occur more frequently in patients with presumed ocular histoplasmosis. Some possible explanations for these associations are discussed. Syphilis, cytomegalic inclusion disease, and toxoplasmosis can all produce a congenital form of uveitis.

Acute Disease↗