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Biomedical subjects

F D Ellis

Publications and source records attributed to F D Ellis.

At least 55 records · Page 3Linked to original sources
PubMed1983

Surgical treatment of congenital esotropia.

We conducted a retrospective study of 133 children (69 boys and 64 girls) who underwent bilateral medial rectus muscle recession (most by the augmented or en-bloc technique) for congenital esotropia. Esotropia was diagnosed before the age of 6 months in 84 patients and after the age of 6 months in the other 49. A total of 27 children underwent surgery before the age of 12 months; of these, three required second procedures. A total of 106 children underwent surgery after the age of 12 months; of these, eight required second procedures. The mean preoperative deviation was 40 prism diopters. Two patients had significant A pattern deviations and 17 had significant V pattern deviations. Six patients had dissociated vertical deviations. Five to 60 days after surgery, 52 patients had no deviation and 99 were within +/- 10 prism diopters of no deviation. Two months after surgery, 67 patients had no deviation and 114 were within +/- 10 prism diopters of no deviation. Final alignments (five months to seven years postoperatively) showed that 51 patients had no deviation and 109 were within +/- 10 prism diopters of no deviation. Despite adequate alignment, none of 13 patients whose esotropia was diagnosed before the age of 6 months, who underwent surgery before the age of 12 months, and who cooperated with testing achieved stereopsis. This suggested that there may be two types of congenital esotropia--one without fusion potential and one in which fusion is possible but lost secondarily because of peripheral esotropic factors.

Child, Preschool↗
PubMed1983

Superior oblique tuck for superior oblique palsy.

Fifty-nine patients with a superior oblique palsy had a superior oblique tuck as part of their surgical treatment. The average size of the tuck was 12.0 mm. All cases had a decrease in the hyperdeviation in the primary position and some decrease in elevation in adduction in the operated eye (Brown's syndrome). Seventeen per cent of the patients required take-down of the tuck three to 24 months after surgery (average time for reoperation, 9.1 months). Symptoms forming indications for take down of the tuck were head tilt, vertical diplopia, torsional diplopia, and a tight feeling on elevation in adduction. No patient who had a tuck alone required take-down. Brown's syndrome was more likely to occur in cases with weakening of the antagonist inferior oblique and when a bilateral tuck of the superior oblique had been done. Taking down of the tucked tendon relieved the symptoms of Brown's syndrome in seven of 10 patients, without a recurrence of superior oblique underaction. After superior oblique tuck in all patients, a residual vertical deviation could be measured and in nearly every case a Brown's syndrome could be found.

Adult↗
PubMed1982

The trochlea. A study of the anatomy and physiology.

Trochleas obtained from fresh surgical specimens, autopsy material, and cadavers were studied by means of dissection, light microscopy, and electron microscopy (scanning and transmission). A bursa-like structure that has not previously been described lines the inner surface of the cartilagenous trochlea. A fibrillar, vascular sheath surrounds the intratrochlear superior oblique tendon. This portion of the superior oblique tendon consists of discrete fibers with few, interfibrillar connections. Each superior oblique tendon fiber is thought to move through the trochlea by means of a sliding action with the central fibers undergoing the maximum excursion.

Cartilage↗
PubMed1981

Aphakic cystoid macular edema in children.

Twenty-five eyes of 18 pediatric patients (aged 7 1/2 months to 14 years 8 months) who had had cataract extractions were examined for evidence of cystoid macular edema (CME) with fluorescein angiography. No patient showed CME when studied from five weeks to four years after surgery. One patient with Peter's anomaly, glaucoma, and chronic iridocyclitis had intense fluorescence of the aqueous and vitreous that precluded evaluation of the macula. Even if this patient is assumed to have had CME, its incidence in our population of aphakic pediatric patients was no more than 4%.

Adolescent↗
PubMed1981

Microcephaly, microphthalmia, falciform retinal folds, and blindness. A new syndrome.

We have observed an apparently new, heritable syndrome consisting of severe microcephaly, microphthalmia, falciform retinal folds, and blindness. Two brothers were affected with these problems. The mother, while she has no ocular malformations, has severe microcephaly and mild mental retardation. The only other offspring of the parents, a boy, is normal. Laboratory evaluation of the affected sibs was uninformative. An environmental cause of this condition has been sought, but none has been identified. Possible modes of inheritance include autosomal dominant inheritance with variable expressivity, X-linked recessive inheritance with partial expression in the mother, or autosomal recessive inheritance that is etiologically unrelated to the mother's microcephaly.

Abnormalities, Multiple↗
PubMed1981

Photo-induced convulsion after using the translid binocular interactor.

A 12-year-old boy with small-angle secondary exotropia and minimal amblyopia experienced photo-induced epilepsy after using the Translid Binocular Interactor, a device designed to treat several of the motor and sensory abnormalities of the eyes alternately with a bright flash at 10 cps. Whether or not the device is effective, it is potentially dangerous to susceptible individuals.

Adolescent↗
PubMed1981

Treatment of congenital glaucoma.

We reviewed 37 consecutive patients who had undergone at least one goniotomy, filtering surgery, and patching for amblyopia because of congenital glaucoma between 1969 and 1979. Of 32 eyes treated for uncomplicated congenital glaucoma, 25 (78%) achieved satisfactory control of intraocular pressure. Seven of the 12 eyes (58%) for which Snellen visual acuities could be obtained had visual acuities of 6/15 (20/50) or better. Of eight eyes treated for complicated congenital glaucoma, four (50%) achieved satisfactory control of intraocular pressure, but the visual acuities of these patients could not be tested.

Acetazolamide↗
PubMed1981

Empirical fitting of hard contact lenses in infants and young children.

A method of empirically fitting hard contact lenses in infants and young children is described. It can be performed without the benefit of "K" readings and does not require the patient to be anesthetized. Lens fit is judged by fluorescein pattern, degree of finger tightness on the cornea, and indirect determination of steepness by comparing baseline refraction with final over-refraction using a contact lens of known power. This simplified technique has been found to be reliable and practical with good lens fit obtained in most patients. The visual results achieved in unilateral aphakic patients using this method are comparable to those found elsewhere in the literature.

Aphakia, Postcataract↗
PubMed1981

Differential intraocular pressure in strabismus diagnosis.

An evaluation of the differential intraocular pressure test in the diagnosis of non-comitant strabismus is described and the results compared with findings in ten normal subjects. Increased intraocular pressure occurring when an eye cannot complete a full duction indicates both the existence of a restriction and the presence of underlying muscle force generation. The differential intraocular pressure test is easily performed, non-invasive, generally reliable, and can be performed on children who are unlikely to cooperate with other types of diagnostic procedures. Although false-negative results may occur, this test nevertheless provides useful additional information to that normally obtained in a motility examination. When combined with passive forced ductions, an accurate picture of both active and passive components of the strabismus may be determined.

Adolescent↗
PubMed1981

Congenital absence of the superior oblique tendon.

Congenital absence of the superior oblique tendon occurred in 18% of patients with a diagnosis of congenital superior oblique palsy who were treated with an attempt at a tuck of the superior oblique tendon. The presence of horizontal strabismus and amblyopia in a patient with diagnosis of congenital superior oblique palsy should raise the possibility of absence of this tendon. Absence of the superior oblique tendon can be treated successfully with weakening of the antagonist inferior oblique, and either recession of the yoke inferior rectus or the ipsilateral superior rectus. The horizontal deviation can be treated with appropriate recession and resection of the horizontal recti.

Amblyopia↗
PubMed1980

Congenital blepharoptosis, anisometropia, and amblyopia.

A review of the records of 65 patients who had surgery for congenital blepharoptosis of the upper eyelid during a three-year period revealed the preoperative presence of anisometropia, strabismus, or amblyopia in 19 patients. Postoperatively, ten of the 65 patients developed or increased their astigmatism in the operated eye. In four of these patients amblyopia attributed to this postoperative astigmatism developed. The results of our study suggest that blepharoptosis surgery done in the first few years of life may contribute to the development of astigmatism and amblyopia in some patients.

Amblyopia↗
PubMed1980

Extraocular muscle-tendon transfer with scleral augmentation.

Two patients with 90 prism diopters of exotropia and an absent medial rectus muscle each had the nasal half of the superior and inferior rectus muscles joined with a thin strip of preserved sclera. The center of the scleral strip was first anchored to host sclera at the usual site of the medial rectus insertion. Alignment was improved in the primary position with a residual exodeviation of 25 prism diopters and 20 prism diopters, respectively. Each patient required secondary conjunctival recession because of a delle.

Female↗
PubMed1980

Differential intraocular pressure as an indirect measure of generated muscle force.

Differential intraocular pressure offers a painless, non-invasive, reliable test for evaluating incomitant strabismus. These data can be used in selecting a recess-resect vs. a muscle transfer procedure and, combined with findings of the traction test, can direct the surgeon in doing a full tendon transfer or a rectus muscle union with recession of the antagonist.

Adolescent↗
PubMed1980

Unilateral cataracts in children.

Our experience in the surgical treatment of unilateral cataracts in children has been presented. Over two-thirds of the patients who were visually mature at the onset of their cataract regained useful vision in the operated eye while less than 10% of the visually immature patients did so. Our findings approximate those found in the literature. While improved visual acuity is the most important objective of unilateral cataract surgery in children, other benefits such as a cleared optical axis often make such surgery desirable, even when the prospect for visual recovery is poor.

Adolescent↗
PubMed1979

Optic chiasmatic glioma in children.

We reviewed the records of 29 patients with optic nerve or chiasm glioma, or both, seen from 1955 to 1966. Sixteen patients were girls and 13 were boys. At the time of diagnosis, 14 patients were less than 2 years old. Optic atrophy was the most frequently seen physical finding, present in 26 of 29 patients. Twelve patients had diencephalic syndrome (41%). Proptosis was seen in eight. Eleven patients (38%) had associated neurofibromatosis. Pneumoencaphalogram was done on 26 patients and was abnormal in 23. The diagnosis was confirmed at surgery in 27 patients. All tumors were astrocytomas. Eighteen patients underwent radiotherapy. Surgery and radiotherapy were used as treatment for optic-chiasmatic glioma with diencephalic syndrome.

Age Factors↗