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Biomedical subjects

S Mutyala

Publications and source records attributed to S Mutyala.

7 recordsLinked to original sources

Contrast sensitivity evaluation after laser in situ keratomileusis.

OBJECTIVE: To determine the effects of laser in situ keratomileusis (LASIK) on best-corrected visual acuity (BCVA) and contrast sensitivity. DESIGN: Prospective, observational case series. PARTICIPANTS: One hundred twelve eyes, in 65 patients with myopia and myopia with astigmatism, who underwent LASIK. TESTING AND MAIN OUTCOME MEASURES: Best-corrected visual acuity using the Snellen visual acuity chart and contrast sensitivity using the CSV 1000 (Vector Vision, Dayton OH) was tested before surgery and 1 week, 1 month, and 3 months after surgery in patients who underwent LASIK. RESULTS: Contrast sensitivity was depressed for patient eyes with spherical equivalence (SE) between -1.25 diopters (D) and -13.75 D, at 12 cycles/degree for at least 3 months and at 18 cycles/degree for 1 week after LASIK. For patient eyes with SE between -1.25 D and -6.00 D, contrast sensitivity was depressed only at 12 cycles/degree for at least 3 months after LASIK. For patient eyes with SE between -6.00 D and -13.75 D, contrast sensitivity was depressed at 6, 12, and 18 cycles/degree 1 week after LASIK but returned toward preoperative levels by 1 month after surgery. Despite the slight decreases in contrast sensitivity, all scores were still within the range of normal values except for 12 cycles/degree for 3 months and 18 cycles/degree at 1 week after surgery in the high myopia group. Although highly myopic patients, compared with patients with low myopia, had slightly less BCVA before surgery, both groups maintained their preoperative BCVA at all postoperative visits. CONCLUSIONS: Based on this study, we conclude that LASIK has little effect on BCVA and contrast sensitivity for up to 3 months after surgery.

Adult↗

Pediatric third, fourth, and sixth nerve palsies: a population-based study.

PURPOSE: To determine the population-based incidence and cause of cranial nerve palsies affecting ocular motility in children in the circumscribed population of Olmsted County, Minnesota. METHODS: The Rochester Epidemiology Project medical records linkage system captures virtually all medical care provided to Olmsted County residents. By means of this database, all cases of third, fourth, and sixth cranial nerve palsy were identified among county residents less than 18 years of age from 1978 through 1992. Medical records were reviewed to confirm the diagnosis, determine the cause, and document county residency. Incidence rates were adjusted to the age and sex distribution of the 1990 white population in the United States. RESULTS: Over this 15-year period, 36 incidence cases of cranial nerve palsy were identified in 35 children in this defined population. The age-adjusted and sex-adjusted annual incidence of third, fourth, and sixth nerve palsies combined was 7.6 per 100,000 (95% confidence interval, 5.1 to 10.1). The most commonly affected nerve was the fourth (36%), followed by the sixth (33%), the third (22%), and multiple nerve palsies (9%). The most common cause was congenital for third and fourth nerve palsy, undetermined for sixth, and trauma for multiple nerve palsies. Although three cases were associated with neoplasia, a cranial nerve palsy was not present at the time of diagnosis in any case. CONCLUSIONS: Unlike many institutionally based referral series, our population-based study provides data on the incidence and cause of third, fourth, and sixth nerve palsies in a geographically defined population. In contrast to previous institutionally based series, nearly half the cases were congenital in origin, and in no case did intracranial neoplasia present as an isolated nerve palsy.

Abducens Nerve↗

Catching up.

The medical school I (S.M.) attended did not require dissection of a cadaver to fulfill the requirements of the anatomy curriculum. I had "learned" human anatomy through lectures, text books, and an atlas, but did no dissection. Although it was difficult doing anatomy that way, I passed basic science exams with high marks and did well on the board exams (NBME). I graduated from medical school with distinction and thought I was well prepared for residency. To my surprise, dissection of the orbit and periorbital regions and cranial cavity were included in my ophthalmology residency and were to pose a challenge for me. I requested the aid of a medical school anatomist to help me face this challenge. Not only did I learn the art of dissection, I gained considerable knowledge in anatomy (much of it clinically relevant), acquired better skill with surgical instruments and enhanced my logical and critical thinking ability. This viewpoint is based upon a diary I kept during my dissection experience.

Anatomy↗

Spontaneous recovery rate in traumatic sixth-nerve palsy.

PURPOSE: To estimate the spontaneous recovery rate of isolated traumatic sixth-nerve palsy. METHOD: A retrospective chart review over a 24-year period at a single institution, excluding patients who were first seen more than 6 weeks after injury, to reduce bias toward nonrecovery. RESULTS: The Kaplan-Meier survival estimate of spontaneous recovery at 6 months was 27% (95% confidence interval [CI], 5% to 44%) in unilateral traumatic sixth-nerve palsy and 12% (95% CI, 0% to 33%) in bilateral traumatic sixth-nerve palsy. CONCLUSION: Spontaneous recovery from isolated traumatic sixth-nerve palsy may be lower than previously reported. A prospective study is needed to provide a more accurate estimate of recovery rate.

Abducens Nerve Injury↗

Mycobacterium fortuitum endophthalmitis.

PURPOSE: The authors report the first known case of mycobacterium fortuitum endophthalmitis. METHOD: The authors use the documentation of clinical course. RESULTS: A postoperative cataract patient received a diagnosis of mycobacterium fortuitum endophthalmitis 1 month after uncomplicated cataract surgery. The endophthalmitis responded to intraocular amikacin. CONCLUSIONS: When mycobacteria are recovered from patients with endophthalmitis, amikacin should be included in the therapeutic regimen until speciation and in vitro susceptibility testing documents equally effective alternatives.

Administration, Topical↗