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Biomedical subjects

Paul E Romano

Publications and source records attributed to Paul E Romano.

At least 19 recordsLinked to original sources

Individual case photogrammetric calibration of the Hirschberg Ratio (HR) for corneal light reflection test strabometry.

PURPOSE: The HR (prism diopters [PD] per mm of corneal light reflection test [CLRT] asymmetry for strabometry) varies in humans from 14 to 24 PD/mm, but is totally unpredictable. Photo(grammetric) HR calibration in (of) each case facilitates acceptable strabometry precision and accuracy. METHOD: Take 3 flash photos of the patient with both the preferred eye and then the deviating eye fixating straight ahead and then again with the deviation eye fixing at (+/-5-10 PD) the strabismic angle on a metric rule (stick) one meter away from the camera lens (where 1 cm = 1 PD). RESULTS: On these 3 photos, make four precise measurements of the position of the CLR with reference to the limbus: In the deviating eye fixing straight ahead and fixating at the angle of deviation. Divide the mm difference in location into the change in the angle of fixation to determine the HR for this patient at this angle. Then determine the CLR position in both the deviating eye and the fixing eye in the straight ahead primary position picture. Apply the calculated calibrated HR to the asymmetry of the CLRs in primary position to determine the true strabismic deviation. CONCLUSIONS: This imaging method insures accurate Hirschberg CLRT strabometry in each case, determining the deviation in "free space", under conditions of normal binocular viewing, uncontaminated by the artifacts or inaccuracies of other conventional strabometric methods or devices. So performed, the Hirschberg CLRT is the gold standard of strabometry.

Blinking↗

A case of acute loss of binocular vision and stereoscopic depth perception. (The misery of acute monovision, having been binocular for 68 years).

PURPOSE: There are few personal reports in the literature, by knowledgeable vision scientists, of the loss of binocular vision. This case is reported. CASE REPORT: This 68 year old retired pediatric ophthalmologist suffered an almost total loss of vision, OD, as a result of a sudden massive hemorrhage into the vitreous body from a bridging retinal vessel, which remained after repair of a spontaneous large horseshoe retinal tear. This caused significant problems with both remaining monocular vision, cognition, and space perception. It was surprisingly disabling. A diary is included. RESULT: The author now appreciates better: 1. that the overlap and cross compensation of monocular vision is quite significant; 2. that monocular depth perception may be impaired by any type of intervening optical media; 3. that a two dimensional world is very different and vastly inferior to a three dimensional world. COMMENT: Such problems are not ordinarily expected or described in these circumstances, but considering what is in the literature, they may be more common and serious than assumed by eye care professionals, and should be taken into consideration in rendering eye care in similar situations. Loss of binocular vision results in a significant handicap even when the vision remaining in the good dominant eye is normal. It is truly remarkable to this victim that so many mature patients are willing to accept this situation in the form of surgical or optical monovision to avoid spectacles for presbyopia.

Acute Disease↗

Followup: a case of acute loss of binocular vision and stereoscopic depth perception. (The misery of acute monovision, having been binocular for 68 years).

This is a continuation of a personal report by a knowledgeable vision scientist, of the loss of binocular vision due to a major vitreous hemorrhage. Please see the initial report for further details. (Romano PE. A case of acute loss of binocular vision and stereoscopic depth perception. (The misery of acute monovision, having been binocular for 68 years) Binocul Vis Strabismus Q 2003; 18:51-55). This report covers months three and four following the hemorrhage. In the two months since the initial report, typical daily problems from this handicap are described. Definite evidence of progressive resolution was finally seen at the end of the third month. The speed of this resolution is about 1% per day!

Acute Disease↗