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Biomedical subjects

L M Hamed

Publications and source records attributed to L M Hamed.

54 records · Page 3Linked to original sources
PubMed1989

Protracted enlargement of the blind spot in multiple evanescent white dot syndrome.

Two patients had protracted blind spot enlargement, photopsia, and no optic disc edema. Both had fundus and fluorescein angiographic findings typical of multiple evanescent white dot syndrome that resolved within several weeks, leaving a persistent enlarged blind spot and photopsia. These clinical findings and an analysis of the literature data suggest that acute idiopathic blind spot enlargement without optic disc edema may be a subset of multiple evanescent white dot syndrome.

Adolescent↗
PubMed1988

Brainstem ocular motility defects and AIDS.

Ocular motility manifestations of focal brainstem dysfunction were the initial clinical features in three patients with human immunodeficiency virus (HIV) infection. These included conjugate gaze palsy with ipsilateral facial paresis, bilateral abducens palsy and a gaze paresis, and homolateral internuclear ophthalmoplegia and abducens nerve paresis. Two patients had focal brainstem lesions as evidenced on neuroimaging. The third showed concurrent infection with Treponema pallidum.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Recurrent anterior ischemic optic neuropathy in young adults.

Anterior ischemic optic neuropathy (AION) is primarily a disease of middle and late life. When it affects the young patient, AION is often due to a specific underlying disease process predisposing to vasculopathy. Reported here are two patients with AION in whom no evidence of associated disease was found. The tendency for recurrent attacks of disc ischemia distinguishes this clinical entity from the more common idiopathic form of AION of older individuals. Hypotheses regarding possible etiology are discussed.

Adolescent↗
PubMed1988

Keratoacanthoma of the limbus.

Unlike keratoacanthomas occurring on the skin, those found on mucous membranes are decidedly rare. We present two cases of keratoacanthoma of the limbal area.

Adult↗
PubMed1987

Hibiclens keratitis.

Presumed accidental corneal exposure to Hibiclens (chlorhexidine 4% and detergent) in two patients resulted in severe and permanent corneal opacification. We investigated the corneal toxicity of Hibiclens by gross, biomicroscopic, and histopathologic studies of rabbit eyes exposed to Hibiclens for varying time intervals ranging from five to 15 minutes. Severe, irreversible, and progressive corneal damage resulted in all eyes studied.

Aged↗
PubMed1987

Persistent binocular diplopia after cataract surgery.

We reviewed the records of 38 consecutive patients who had persistent binocular diplopia after cataract surgery. The patients were divided into ten categories based on the suspected conditions underlying the diplopia. Of 16 patients who underwent strabismus surgery, five achieved the therapeutic goal of single binocular vision in the primary and reading position, and four attained this with prismatic or botulinum toxin therapy in addition to surgery. Seven patients continued to have diplopia despite strabismus surgery and adjunctive therapy. Even small residual deviations were often intolerable, because of highly diminished fusional amplitudes.

Adult↗
PubMed1987

Evaluation of an absorbable muscle sleeve to limit postoperative adhesions in strabismus surgery.

A muscle sleeve fashioned from polyglactin 910 Vicryl mesh was used in a rabbit animal model to evaluate its efficacy in decreasing postoperative adhesions encountered in extraocular muscle surgery. Clinical observations, as well as gross and histological comparison of the experimental and control groups, revealed a significant reduction in postoperative adhesions under conditions of normal surgical trauma. Where there was extensive trauma, however, no significant reduction was observed. No evidence of toxicity of the material to ocular tissues was found.

Animals↗
PubMedDate not supplied

Ocular syphilis.

There has been a steady increase in the number of cases of syphilis in the United States since the middle 1980s, with a dramatic rise in incidence among heterosexual men and women and of congenital syphilis. There also have been changes in geographic distribution of cases and an association with cocaine use. The ophthalmologic manifestations of syphilis are broad. There is anecdotal evidence that the natural history of syphilitic infection is altered by coinfection with human immunodeficiency virus. The potential of coinfection with HIV makes the clinical evaluation, treatment, and assessment of therapeutic outcome of syphilitic infection more confounding and controversial. This article provides a review of the changing demographics and ophthalmic manifestations of syphilis, the current status of laboratory testing techniques, and management approaches to various types of ocular syphilis.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Magnetic resonance angiography of vascular lesions causing neuro-ophthalmic deficits.

Magnetic resonance angiography (MRA) is a noninvasive, rapidly evolving technique for imaging the intra- and extracranial carotid and vertebrobasilar circulations. It may in some circumstances obviate conventional angiography and the accompanying risks associated with catheterization and contrast injection. MRA exploits the different physical properties between moving protons and stationary tissue to yield flow sensitive data in the form of anatomic images or velocity and flow measurements. Since patients with various vascular disorders may present exclusively with ophthalmologic signs and symptoms, it is expected that MRA will become more frequently utilized by ophthalmologists. The exact role of MRA in the workup of vascular disorders remains to be more precisely defined, pending the performance of additional well-controlled standardized studies. At present, MRA is utilized to complement the conventional spin-echo studies of patients with arterial and venous occlusion, vascular malformations, intracranial aneurysms, and neoplastic vascular invasion. With further refinements, it is expected that MRA will become a standard diagnostic tool for the evaluation of patients with vascular disorders.

Blood Flow Velocity↗
PubMedDate not supplied

Spontaneous orbital hemorrhage during general anesthesia and arthroplasty.

A 72-year-old woman who had a history of arthritis and cerebral vascular accident 4 years earlier underwent hand surgery. Because regional anesthesia was not successful, general anesthesia was administered. Shortly before extubation, proptosis developed in her left eye, and she was unable to open it. The condition was due to spontaneous orbital hemorrhage and resolved with conservative treatment.

Aged↗
PubMedDate not supplied

Thyroid eye disease presenting after cataract surgery.

Strabismus presenting after cataract surgery has been attributed to a variety of disorders, some of which are unrelated to the surgery. When thorough ophthalmologic and neurologic examinations fail to elucidate a definitive etiology, the motility disturbance is often ascribed to operative trauma to the orbital soft tissues. In a series of 58 patients with strabismus presenting after cataract surgery, eight (14%) were found to have previously unsuspected thyroid eye disease. Three of the eight patients had past histories of systemic dysthyroidism, but none reported diplopia prior to cataract extraction. Three of the remaining five patients showed normal thyroid function tests. Absence of diplopia prior to cataract extraction in these patients may be due to: 1) poor vision precluding diplopia until surgical restoration of sight; 2) intraoperative aggravation of the inflammatory process in otherwise subclinical thyroid eye disease; or 3) onset of clinical thyroid eye disease that was temporally associated with cataract surgery by chance. Thyroid eye disease should be included in the differential diagnosis of all patients presenting with binocular diplopia following cataract surgery. Suitable neuroimaging studies may be needed to confirm the diagnosis.

Aged↗
PubMedDate not supplied

Synergistic divergence and jaw-winking phenomenon.

Synergistic divergence is a congenital syndrome of monocular adduction deficit, with simultaneous abduction of both eyes on attempted gaze into the field of action of the paretic medial rectus muscle. Based on electromyographic data, it has been speculated that it is a neural miswiring disorder related to Duane's retraction syndrome. The association between Duane's retraction syndrome and the Marcus Gunn jaw-winking phenomenon, another neural miswiring disorder, has been previously reported. The authors describe a patient with both bilateral synergistic divergence and Marcus Gunn jaw-winking phenomenon.

Adolescent↗
PubMedDate not supplied

Bilateral Brown syndrome in three siblings.

The vast majority of cases of Brown syndrome are considered to be of a nonfamilial, sporadic nature. Documented instances of familial transmission are rare. All three siblings in one family pedigree showed bilateral Brown syndrome. Other family members were reportedly unaffected. The current cases, along with previous reports, support the concept that a subset of congenital Brown syndrome may have a strong hereditary basis, being transmitted either as an autosomal recessive genetic trait or an autosomal dominant disorder with decreased penetrance.

Adolescent↗
PubMedDate not supplied

Synergistic divergence: saccadic velocity analysis and surgical results.

The clinical findings are described in four patients with synergistic divergence (SD), an ocular motility disorder which is considered to be a variant of Duane retraction syndrome (DRS). Saccadic velocity studies in three patients demonstrated preserved abducting saccades in the affected eye with equally reduced amplitudes on both attempted abduction and adduction. The preserved saccades on attempted abduction of the affected eye, coupled with electromyographic evidence that shows maintenance of normal reciprocal innervation with respect to gaze on attempted abduction as dictated by Sherrington's law, strongly suggest that the abducens nerve is not necessarily absent or severely hypoplastic in this condition. One patient showed typical DRS in the contralateral eye and had a son with bilateral DRS, attesting to a possible genetic and etiologic relationship between SD and DRS. Three patients underwent strabismus surgery. Review of our surgical results and an analysis of the literature indicate that a crippling procedure to the ipsilateral lateral rectus muscle, such as extirpation, may be necessary to eliminate simultaneous abduction. Overcorrection did not occur following lateral rectus extirpation.

Adolescent↗
PubMedDate not supplied

Periodic alternating esotropia.

Periodic alternating esotropia (PAE) is a rare ocular motility disturbance observed in association with periodic alternating gaze deviation (PAG) or periodic alternating nystagmus. We examined a 9-month-old developmentally delayed girl who showed PAE occurring synchronously with PAG. The ocular motility disorder consisted of rhythmic alternating fixation with the right eye in abduction, a left face turn and esotropia of the left eye (90 seconds), a changeover phase (10 to 15 seconds) during which the eyes are straight and the head is upright, then fixation with the left eye in abduction, a right face turn, and esotropia of the left eye (90 seconds). There was no spontaneous jerk nystagmus present. These findings continued incessantly during a follow-up period of 18 months. Magnetic resonance imaging revealed pronounced cerebellar vermis hypoplasia. Only three clinically similar cases have been previously reported, but none had been studied with modern neuroimaging techniques.

Atrophy↗
PubMedDate not supplied

Intact binocular function and absent ocular torsion in children with alternating skew on lateral gaze.

BACKGROUND: A form of skew deviation, called alternating skew on lateral gaze, resembles bilateral superior oblique overaction. Oblique muscle overaction has been recently speculated to result from loss of fusion with subsequent "free-wheeling" of the torsional control mechanisms of the eyes, causing sensory intorsion or extorsion with attendant superior or inferior oblique muscle overaction, respectively. We wanted to investigate whether loss of fusion plays a role in the pathogenesis of alternating skew on lateral gaze. SUBJECTS AND METHODS: We examined seven consecutive patients with posterior fossa tumors, enrolled in a multi-disciplinary pediatric neuro-oncology program, who displayed alternating skew on lateral gaze. All patients underwent a thorough ophthalmologic evaluation. RESULTS: Visual acuities in the study patients ranged from 20/20 to 20/40. Five of the seven patients were orthotropic, and showed 40 sec of arc stereopsis. Three patients showed associated downbeat nystagmus. No ocular torsion was found in any of the five patients who showed normal stereopsis upon inspection of fundus landmarks on indirect ophthalmoscopy. CONCLUSION: Patients with alternating skew on lateral gaze often have normal binocular vision and stereopsis, and lack ocular intorsion so typical of superior oblique overaction. Alternating skew on lateral gaze is neurologically mediated, with no role for defective fusion in its pathogenesis.

Adolescent↗