Biomedical subjects
Publications and source records attributed to F D Ellis.
An 11-year-old boy developed generalized tetanus complicated by a supranuclear gaze palsy and exotropia. This case led us to include supranuclear palsy in an expanded definition of cephalic-tetanus.
Bimedial rectus recession with measurement from the limbus was combined with conjuctival recession 85 children undergoing surgery for esotropia. Using this augmented recession technique, the prism diopters of correction per millimeter of surgery done were 4.8 compared with 3.2 found in 56 control patients. Postoperatively, the conjunctiva had a satisfactory cosmetic appearance and ductions were normal.
Explore the source record for details and available documents.
We report the rapid healing of several cases of marginal corneal ulceration of various aetiologies after the excision of a 4 to 7 mm strip of adjacent limbal conjunctiva. After conjunctivectomy the remaining conjunctiva was loosely recessed (without sutures). In one case with coexisting scleromalacia, we excised strips of adjacent bulbar conjunctiva with equally good results. Some of the cases had failed to respond to other modes of treatment including topical collagenase inhibitors. One case responded to peritomy and cryotherapy to the ulcer edges, but we have abandoned this treatment in favour of conjunctival excision. Limbal conjunctivectomy with recession is presumed to act by eliminating conjunctival sources of collagenase and proteoglycanase.
A review of 130 cases of superior oblique palsy suggests that simple office procedures are sufficient to establish the diagnosis. Prism and cover test measurements with alternate eyes fixing in the nine diagnostic positions of gaze proved to be the greatest help in classifying these cases with regard to surgical planning.
Strabismus surgery continues to present a challenge to the ophthalmologist who evaluates results critically. Precise diagnoses and expert surgical judgment never will be supplanted by tools and techniques. Nevertheless, by remaining aware of newer surgical procedures and improved instrumentation, the strabismus surgeon will continue to increase the probability of achieving desirable surgical results.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A 6-year-old white female was found to have an adenoid cystic carcinoma originating in a lacrimal gland. Eighteen months following diagnosis, the tumor recurred. Conservative surgery has been the sole mode of therapy. To date, after four operations and quadrimenstral imaging surveillance, there is no sign of disease progression. Our purpose is to record the unusual occurrence of an adenoid cystic carcinoma of the lacrimal gland in a child. An interim report, 32 months after diagnosis, is presented.
Silicone tube intubations were performed on 36 cases of congenital nasolacrimal obstruction and on three children with traumatic canalicular lacerations. The success rates of 84% in congenital nasolacrimal duct obstructions, 54% in congenital punctal-canalicular obstructions, and 100% in canalicular lacerations and the minimal complications encountered suggest that silicone intubations in the pediatric population are useful in avoiding dacryocystorhinostomy and conjunctivo-dacryocystorhinostomy.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A performance test is proposed as an addition to the routine eye examination of the child performing poorly in school. Performance on the "draw a bicycle test" has a strong correlation with academic performance among children in grades one through three. Poor performance on the "draw a bicycle test" by children who have otherwise normal eye findings implicates a non ocular cause for the poor academic performance. Since the results of this simple test are immediately visible and readily understood by an attending parent, the ophthalmologist's role in counseling the parents against further ocular investigation and therapy is apparent.
The charts of all patients with the diagnosis of congenital Brown's syndrome seen between July 1983 and June 1984 were examined retrospectively. In the past, overaction of the ipsilateral superior oblique (OAISO) was felt by most authors to be absent or minimal. Our study revealed that separate observers consistently documented the presence of an OAISO in about one-fifth of the selected patients. The presence of OAISO has not been emphasized previously and still remains controversial. We felt that an extremely tight superior oblique might cause an OAISO. We therefore statistically compared its presence to the presence of a downshoot. The presence of an OAISO to abnormal head tilt, abnormal chin position, amblyopia, and abnormal stereo was also compared statistically. Finally, we emphasize a technique of forced ductions that differentiates Brown's syndrome from an inferior oblique palsy, but which also alerts the examiner to the presence of an inferior rectus restriction or other posteriorly located restrictions.
Retinoblastoma was diagnosed in 74 patients between July 1967 and February 1987. Thirty cases (40%) were bilateral; 39 were female and 35 were male. Treatment in bilateral cases consisted of enucleation of the more involved eye and a combined approach of supervoltage irradiation, cryocoagulation, and photocoagulation to the remaining eye. In unilateral cases the involved eye was enucleated and the uninvolved eye observed. Four patients had bilateral enucleation at their initial presentation and four others had the second eye enucleated after unsuccessful tumor treatment. One patient died from metastatic retinoblastoma, one patient died after intrathecal chemotherapy without the evidence of tumor, and one patient died with trilateral retinoblastoma. Seventy-one of 74 patients (96%) currently survive with a follow-up of 1 month to 19 years. Two-year survival is 65 of 68 (95.5%).
The presence of cystoid macular edema (CME) after cataract extraction in the pediatric age group could adversely affect rapid visual rehabilitation of the eye by contributing to irreversible amblyopia. Several previous studies, including one by our group, have addressed this problem. Hoyt's observations of CME in ten of 27 eyes undergoing lensectomy-vitrectomy procedures have stirred renewed interest in this topic. The current study includes 12 eyes undergoing lensectomy-vitrectomy procedures, five eyes undergoing manual extracapsular procedures (ECCE) with discission of the posterior capsule, three eyes undergoing ECCE without discission of the posterior capsule, and three eyes undergoing secondary discissions. No CME was found angiographically on postoperative evaluation.
Explore the source record for details and available documents.
Explore the source record for details and available documents.