Transducer for recording fine eye movement through the closed eyelid.
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Biomedical subjects
Publications and source records attributed to J G Thomas.
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An electronic method has been used to record the micro-tremor of the eyes of a group of comatose patients. Changes in the micro-tremor waveform patterns have been observed in successive records taken over a period of several days. These changes have been associated with changes in the depth of coma.
The normal ocular microtremor possesses certain characteristics. Abnormal records are found in unconscious patients. Six patients with clinical manifestations of brain death showed complete absence of ocular microtremor when it was recorded shortly before death. A seventh patient who had taken an overdose of barbiturates had a virtually flat record which gradually improved as her coma lightened. The ocular microtremor record is proposed as a potential monitor of brain stem viability or death.
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A physical examination checklist of 25 signs of Down's syndrome was used to predict the presence of absence of 21-trisomy in 291 individuals examined for suspected Downs syndrome. Using only total numbers of signs present, 21-trisomy was unambiguously predicted in about half those examined. Discriminant analysis using the most informative 10 signs misclassified only 11 of 169 infants aged 2 years or less, and allowed non-overlapping classification into Down's and non-Down's of almost three-fourths of suspected individuals. The risk for Down's syndrome in the overlap area was 58%.
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Twenty-two patients and 7 normal subjects at the Burdenko Institute of Neurosurgery, Moscow, have taken part in an investigation in which the direct light reflex to a brief flash, and the high-frequency microtremor of the eyes, have been recorded. The direct pupil reflex recordings obtained with a flash of 20 msec duration and 100 lux intensity at the plane of the pupil were registered from the right eye of each patient. Ocular microtremor recordings were obtained simultaneously from both eyes of 20 of the patients. A set of criteria of abnormality of ocular microtremor, as judged by visual examination of the records, is proposed by the authors. Abnormality of the pupil reflex is assessed in terms of the amplitude, latent period, and time course of the contraction and relaxation phases of the reflex. A strong correlation has been found between the occurrence of an abnormal ocular tremor record and an abnormal pupil reflex. On the basis of this correlation, the authors propose that ocular tremor recordings may be used in diagnosis as sensitive indicators of brain-stem dysfunction.
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