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Biomedical subjects

I C Lloyd

Publications and source records attributed to I C Lloyd.

32 records · Page 2Linked to original sources

A mutation in the RIEG1 gene associated with Peters' anomaly.

Mutations within the RIEG1 homeobox gene on chromosome 4q25 have previously been reported in association with Rieger syndrome. We report a 3' splice site mutation within the 3rd intron of the RIEG1 gene which is associated with unilateral Peters' anomaly. The mutation is a single base substition of A to T at the invariant -2 site of the 3' splice site. Peters' anomaly, which is characterised by ocular anterior segment dysgenesis and central corneal opacification, is distinct from Rieger anomaly. This is the first description of a RIEG1 mutation associated with Peters' anomaly.

Child, Preschool↗

Anterior segment dysgenesis in mosaic Turner syndrome.

AIMS/BACKGROUND: Females with Turner syndrome commonly exhibit ophthalmological abnormalities, although there is little information in the literature documenting findings specific to Turner syndrome mosaics. Ophthalmic findings are described in four patients with mosaic Turner syndrome. All had anterior chamber abnormalities and all four had karyotypic abnormalities with a 45, X cell line. The possible relation between the karyotypic and the phenotypic findings in these patients is discussed. METHODS: Four girls with mosaic Turner syndrome underwent a full ophthalmological assessment, including examination under anaesthesia where indicated. RESULTS: Three of the four patients presented with congenital glaucoma. Two had the karyotype 45, X/46, X, idic(Y) and one a 45, X/47, XXX karyotype. The remaining child had a Rieger malformation of the iris and the karyotype 45, X/46, X, r(X). CONCLUSIONS: These findings suggest that Turner syndrome mosaicism (where there are two abnormal cell lines) is associated with anterior segment dysgenesis. The findings in these four patients are compared with those seen in other mosaic phenotypes and it is postulated that the presence of two or more genetically different cell lines may have an adverse effect on anterior segment development.

Anterior Chamber↗

Investigation of microbial keratitis: an audit from 1988-1992.

An audit was performed of the investigation of 263 cases of microbial keratitis severe enough to be admitted to the Manchester Royal Eye Hospital over the 5-year period, 1988-1992. A pathogen isolation rate of 37% was noted during the first year which increased to 79% (p < 0.05) by the final year of audit. In late 1991 a new method of inoculating enrichment broths was introduced, which also contributed by increasing the yield from corneal scrapes. The audit process resulted in the development of and adherence to our investigation protocol, improved communication between Manchester Royal Eye Hospital and the microbiology laboratory, the implementation of a new investigatory method, and a significantly improved microbial isolation rate.

Adolescent↗

Implantation of foldable intraocular lenses in the presence of anterior capsular tears.

A consecutive series of patients who had undergone small-incision phacoemulsification cataract surgery with foldable lens implantation were reviewed. Seven patients had sustained anterior capsular tears during surgery. In all cases a three-piece foldable intraocular lens (IOL) was successfully inserted by careful positioning of the haptics. In all 6 patients available for long-term assessment the IOL remained stable and well centred, the tears having been sealed by fibrous tissue. We show that, if logical measures are taken to limit tear extension, the lack of an intact capsulorhexis need not result in conversion to extracapsular cataract extraction.

Astigmatism↗

Modulation of amblyopia therapy following early surgery for unilateral congenital cataracts.

BACKGROUND: Stimulus deprivation amblyopia is the principal cause of visual impairment in infants with unilateral congenital cataract. Even if lensectomy is undertaken at an early age, intensive postoperative occlusion of the phakic eye is essential for the development of useful vision in the aphakic eye. Despite this, the optimum method of regulating occlusion therapy is uncertain. METHODS: Interocular acuity differences identified using clinical preferential looking techniques (Keeler cards) were used to regulate target levels of phakic eye occlusion in a prospective evaluation of 10 systemically, metabolically, and neurologically normal infants in whom dense unilateral cataract was diagnosed before 8 weeks of age, and operated upon by 10 weeks. Actual occlusion levels were recorded each day by parents in a diary. The development of preferential looking acuity in the phakic and aphakic eye were compared with prediction intervals derived from observations on 43 normal children. RESULTS: Aphakic eye preferential looking acuities were within the normal range at last review in all but one infant. Interocular acuity differences were < or = 0.5 octave in all children older than 1 year of age at last review, and > or = 1 octave in three of four children less than 1 year old at last review (Fisher exact p = 0.033). Phakic eye acuities were within the normal range in all infants at all visits. CONCLUSION: Within the first 2 years of life, normal preferential looking acuity may be achieved in both eyes of infants undergoing early surgery for unilateral congenital cataract if occlusion therapy is modulated according to interocular acuity differences quantified by clinical preferential looking techniques.

Amblyopia↗

Neonatal cataract: aetiology, pathogenesis and management.

We review the epidemiology, aetiology, pathogenetic mechanisms and clinical management of neonatal cataract. Visual development and the effects of visual deprivation in the infant with congenital cataract are discussed and related to the timing of surgery. Surgical techniques and the important operative and post-operative complications are discussed. We review post-operative management and compare the different techniques available for aphakic correction, and describe the VEP changes found in patients with monocular cataract.

Cataract↗

Aspects of albinism.

Genetic, clinical and electrophysiological aspects of albinism are described. Emphasis is placed on electrophysiological features which help to distinguish albinism from other clinical conditions, and on stimulating and recording factors which can affect the clarity of VEP results.

Albinism, Ocular↗

Solitary extramedullary plasmacytoma of the maxillary antrum and orbit presenting as acute bacterial orbital cellulitis.

Orbital involvement by plasma cell tumours is rare. Orbital tumours do not generally present as an acute orbital inflammatory disease in adults, though tumours such as rhabdomyosarcoma may cause clinical signs similar to an acute orbital cellulitis in children. We describe a patient with bacterial orbital cellulitis and sinusitis who was found to have an extra-medullary plasmacytoma of the maxillary antrum and orbit and coexisting testicular seminoma.

Cellulitis↗

General practitioner referrals to an eye hospital: a standard referral form.

To assess general practitioner (GP) referrals to an eye hospital, 500 consecutive referral letters were analysed for content, diagnosis, ocular examination, and medical and drug history. Inadequate information was provided. Visual acuity was measured by general practitioners in only 3.7% of referrals. The standard of ocular examination compared unfavourably with that of ophthalmic opticians. A standard ophthalmic referral form is proposed, and referral protocols are desirable. Undergraduate education in ophthalmology is inadequate and requires more curricular time.

Correspondence as Topic↗

Cavernous haemangioma of the orbit.

Cavernous haemangioma is considered to be the most common primary orbital tumour. We present 3 cases of cavernous haemangioma of the orbit managed by medial orbitotomy combined with medial orbital decompression. This approach was performed for lesions occurring medial to the optic nerve in an attempt to reduce the surgical morbidity reported following lateral orbitotomy or transcranial orbitotomy.

Adult↗