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Biomedical subjects

S Sandramouli

Publications and source records attributed to S Sandramouli.

33 records · Page 2Linked to original sources
PubMed1997

Retinal haemorrhages and convulsions.

AIMS: To evaluate the incidence of retinal haemorrhages after convulsions in children. PATIENTS AND METHODS: All children who required hospital admission after an episode of convulsions were included in the study. Complete neurological and ocular examinations, including ophthalmoscopy, were undertaken within 48 hours of hospital admission. RESULTS: Thirty three children were examined according to the protocol and their seizures were classified by a paediatric neurologist. Despite the fact that some of the children also vomited or underwent cardiopulmonary resuscitation, none of the 33 children developed retinal haemorrhages. CONCLUSIONS: Convulsions rarely (if ever) give rise to retinal haemorrhages. The finding of retinal haemorrhages should stimulate a detailed assessment to exclude non-accidental injury, whatever the nature of the associated or antecedent events.

Adolescent↗
PubMed1994

Aqueous humour lactic acid and proteins in eyes with iris neovascularization.

The content of lactic acid and proteins in the aqueous humour of eyes with neovascularization of the iris (NVI) of various etiology was determined. The results were analysed for any possible correlation with the angiogenesis observed in such eyes. Aqueous humour from patients with immature senile cataracts served as the control. The total protein concentration in cases of NVI (mean +/- SD, 345.7 +/- 161.0 mg/dl; n = 15) was significantly raised (P < 0.001) as compared with the control values (mean +/- SD, 30.91 +/- 14.95 mg/dl; n = 12). On the other hand, the concentration of lactic acid in cases of NVI (mean +/- SD, 45.97 +/- 15.5 mg/dl; n = 13) was significantly lower (P < 0.01) as compared with the controls (mean +/- SD, 65.86 +/- 10.9 mg/dl; n = 8). These findings show that angiogenesis is not associated with a raised level of lactic acid in the aqueous humour, whereas the elevated protein values are suggestive of a breakdown of the blood-aqueous barrier.

Adult↗
PubMed1993

Role of anterior retinal cryoablation in the management of neovascular glaucoma.

In a prospective study, the effect of anterior retinal cryoablation (ARC) in the management of neovascular glaucoma (NVG) was evaluated over two years, in 72 patients (74 eyes). The outcome of trabeculectomy/seton surgery preceded by 360 degrees ARC was also analysed in 12 eyes of 12 patients (6 eyes in each group). Following ARC, pain relief with dramatic regression of anterior chamber inflammatory reaction was observed in 95% of the patients (59 eyes). At the end of the follow up, as confirmed by iris fluorescein angiography, regression of neovascularization of the iris was documented in 93.5% (58 eyes) of the cases. Intraocular pressure control (< or = 22 mm Hg) was achieved in 82.3% (51 eyes) cases. IOP control of < or = 22 mm Hg was achieved in all the 6 eyes with the seton surgery following ARC. Similarly, control of IOP was successfully achieved in all the 6 eyes of patients with NVG with trabeculectomy with post operative course of 5-fluorouracil following ARC. ARC is strongly recommended in NVG, especially in eyes with media opacities and as a preliminary procedure for filtering surgery or drainage implant surgery.

Adolescent↗
PubMed1993

Subconjunctival dislocation of posterior chamber intraocular lens.

A posterior chamber intraocular lens (PC-IOL) dislocated into the subconjunctival space following a concussion injury in a 24-year-old man who had gained good visual acuity following extracapsular cataract extraction and PC-IOL implantation for a steroid-induced cataract. Except for long-term use of topical steroid therapy for vernal catarrh, the patient had no systemic or ocular predisposing factors for wound dehiscence. Given the risk of endophthalmitis, the PC-IOL was removed and anterior vitrectomy was performed on an emergency basis. To our knowledge, this is the second documented case of a subconjunctivally dislocated PC-IOL.

Adult↗
PubMed1993

Sturge-Weber syndrome: management of glaucoma with combined trabeculotomy-trabeculectomy.

We reviewed the records of 16 patients (19 eyes) with Sturge-Weber syndrome (SWS). Scleral pigmentation was present in 12 (63.2%) of these eyes; nevus of Ota in two (10.6%). Combined trabeculotomy-trabeculectomy was performed in 18 eyes. After a mean follow up of 42 months (range, 1 to 8 years), intraocular pressure was controlled (< or = 22 mm Hg) in 11 eyes (61.1%), and visual acuity was better than 6/60 in eight. Intraoperative hyphema occurred in four eyes (22.2%); vitreous loss in three (16.7%). Postoperative choroidal detachment occurred in three eyes (16.7%); vitreous hemorrhage in one (5.6%). In all of the cases of repeat surgery (three eyes), postoperative subconjunctival injections of 5-fluorouracil resulted in a diffuse filtering bleb. We conclude that combined trabeculotomy-trabeculectomy is a promising treatment for patients with SWS with glaucoma.

Child↗
PubMed1993

Laboratory diagnosis of keratomycosis: comparative evaluation of direct microscopy and culture results.

In a prospective study, we evaluated the sensitivities of direct microscopy using potassium hydroxide 10% wet-mount preparations and culture for definitive diagnosis of keratomycosis in 171 clinically suspected fungal corneal ulcers. Although cultures were positive in 88 eyes (51.46%), the fungus could be demonstrated by KOH preparation in 94.3% (83 of 88) of the culture-proved cases and 93.6% (160 of 171) of the overall eyes. Direct microscopic examination of a KOH wet-mount preparation is a rapid, reliable, and superior technique of laboratory diagnosis. It is particularly important for the early initiation of antifungal treatment in mycotic keratitis.

Adolescent↗
PubMed1993

Ocular ethambutol toxicity: is it reversible?

Delayed onset ocular ethambutol toxicity is usually considered to be reversible following prompt withdrawal of the drug. However, in a series of seven consecutive patients with severe visual deficit due to ethambutol toxicity, only 42.2% (3 of the 7 patients) achieved a visual recovery of better than 20/200 after an average follow-up of 8.3 +/- 2.1 months after stoppage of the drug. On fluorescein angiography, three cases (42.2%) progressed to optic atrophy during the follow-up with permanent visual damage. There were no predisposing or risk factors to contribute toward the poor visual gain. In this background, we recommend discontinuation of ethambutol from the antituberculous regimen. As an additional sidelight, the value of visually evoked potential in the monitoring of patients on ethambutol, especially in cases with early periaxial neuritis, has been emphasised.

Adolescent↗
PubMed1992

Direct scleral fixation of posterior chamber intraocular lenses using a special needle-holder.

We report a modified technique of direct scleral fixation of a posterior chamber intraocular lens (PC-IOL) using a specially designed intraocular needle-holder. The procedure was carried out in three eyes with posttraumatic subluxated cataracts; one with aphakic bullous keratopathy and with an accidental posterior capsular rent, and one with a superior zonulodialysis. The needle-holder greatly facilitated the procedure, enabling us to place the PC-IOL precisely in the ciliary sulcus with no subsequent decentration. This method avoids iris fixation and provides more secure scleral fixation of the PC-IOL.

Adult↗
PubMed1992

Bilateral congenital posterior-capsular defects: a case report.

We report a rare case of bilateral congenital posterior-capsular defects and its successful management by the dry-aspiration technique. To our knowledge, this is the first documented case of a posterior-capsular rupture with no demonstrable cause.

Cataract↗
PubMed1991

A prospective evaluation of anterior retinal cryoablation in neovascular glaucoma.

We report a prospective evaluation of the effect of anterior retinal cryopexy on 62 eyes with neovascular glaucoma. Pain was relieved and anterior chamber inflammatory reaction regressed dramatically in 95%. Iris neovascularization was reduced or regressed in 93.5%. Control of intraocular pressure was clinically significant in 82.3% 1 year after the procedure, especially in patients with pretreatment pressures less than 40 mm Hg on maximal medical therapy. Anterior retinal cryopexy is recommended in eyes with media opacities and as a preliminary procedure for filtering surgery in eyes with neovascular glaucoma.

Adolescent↗
PubMed1991

Contact thermal burns of the cornea.

The records of 59 patients (66 eyes) with contact thermal burns of the cornea (unilateral in 52 cases and bilateral in 7) were reviewed to determine the causes, clinical presentation, management and complications of such injuries. Most of the injuries (90%) occurred at home. The commonest cause was splashing of boiling fluids (42% of cases), followed by contact with red-hot firecracker particles (18%) and lit match heads (17%). In 59 eyes (89%) the burn was limited to the corneal epithelium, in 5 (8%) the superficial stroma was also involved, and in 2 (3%) there was associated corneal perforation caused by mechanical impact of foreign bodies. Débridement of the coagulated epithelium with patching was the most successful treatment, healing 48 (73%) of the eyes. Postburn complications were rare, the most common being development of inferior symblepharon, in three eyes (4%).

Adolescent↗
PubMed1991

Types of posterior capsular breaks and their surgical implications.

We studied the pathogenesis, clinical features, and management of posterior capsular breaks in 28 cataract patients during planned extracapsular cataract extraction and intraocular lens implantation surgery. In the age-related cataract group (17 cases), the posterior capsular breaks were fresh, caused by the irrigation-aspiration cannula. Located in the upper part of the posterior capsule, they had thin margins and tended to enlarge with continued irrigation. Nine (52.9%) of these breaks could be plugged with viscoelastic, and after dry aspiration, a posterior chamber lens was implanted successfully. Posterior capsular breaks in traumatic cataracts (11 cases) were preexisting but were detected only during surgery. Centrally located, they had thick fibrosed margins and remained the same size during irrigation- aspiration. The minimal vitreous herniation seen in four (35.3%) of these cases was managed by automated partial anterior vitrectomy through the break. A posterior chamber intraocular lens was implanted in all these cases.

Adolescent↗
PubMedDate not supplied

Indications and outcome of carotid Doppler ultrasound: an ophthalmic perspective.

PURPOSE: The purpose of this study was to assess indications and outcome of carotid Doppler ultrasound requested by ophthalmologists from an eye hospital over a period of three years. METHODS: This retrospective study was designed to analyse data for all patients referred to have carotid Doppler ultrasound from 1999 to 2001. Colour fundus photograph was used to ascertain diagnosis of ocular condition. Detailed case note analysis was done to correlate patient details, indication, results of carotid Doppler, and status of anti-platelet treatment as well as presence of other risk factors. RESULTS: 107 patients were included in the study. 46.7% had normal internal carotid on Doppler while 53.3% patients had stenosis, 22.8% of which were significant. 15 out of 24 patients with retinal artery occlusion had internal carotid artery (ICA) stenosis. 2 out of 6 patients with migraine had significant stenosis. 12 patients had retinal vein occlusion (5 were bilateral), 9 of whom showed ICA stenosis. 14 of 15 patients with retinal emboli had stenosis of ICA. Other diagnoses included anterior ischaemic optic neuropathy, cranial nerve palsy, etc. 42 patients had 1 to 3 risk factors, and 11 patients had more than 3 risk factors. Ophthalmologists started anti-platelet management in 24 patients (42.1%) with some degree of ICA stenosis. CONCLUSIONS: Approximately 55% of our patients referred for carotid Doppler were positive for ICA stenosis with nearly a fifth of such referrals having more than 70% stenosis, which is considered to be clinically significant. Our results highlight the importance of such referrals for carotid Doppler for various ophthalmic conditions by the ophthalmologists.

Aged↗