[Pattern-reversal-VEP in the diagnosis of drusen and papilledema].
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Biomedical subjects
Publications and source records attributed to T Neuhann.
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The contribution of ophthalmology in the diagnostic evaluation of a patient with headache is outlined. When asthenopia or an organic eye disease is cause of the headache, the ophthalmologist cannot only diagnose the etiology but can also cure the patient by adequate therapy. When the headache is sign of CNS-disease, the ophthalmologist can provide the neurologist with valuable information regarding nature and localization of the process.
Intraocular pressure was measured in 49 persons of either sex while carrying out Valsalva's maneuver in erect and recumbent position. 16 of the tested persons had myopia up to -8.0 D. The average intraocular pressure in recumbent position was 2 mm Hg higher when compared to the erect position. During Valsalva's maneuver the intraocular pressure was elevated in erect as well as in recumbent position. Three characteristic patterns of variation of intraocular pressure were seen after cessation of Valsalva's maneuver. The intraocular pressure in myopic persons was slightly higher than in those with emmetropia.
The quality of binocular vision in unilateral aphakia was tested in presbyopic patients. 10 of them were corrected by a contact lens, 10 by an intraocular implant. Unilateral aphakic young patients were submitted to the same tests. In the young patients the unilateral accommodation proves to be the main obstacle to binocularity. In the presbyopics there is no difference between intraocular and contact lens correction as to the quality of binocular functions. Which one of these two alternatives for the correction of unilateral aphakia should be preferred in the individual case must, therefore, be decided upon by other criteria than binocular vision. The results with unilateral spectacle correction demonstrate that binocular vision cannot be achieved by compensation of aniseikonia alone.
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The authors describe a cataract incision technique, which combines the advantages of the corneoscleral site (conjunctival covering, mechanical strength of the resulting scar) with those of a corneal incision (sparing of the angle structures, good visibility, simple and nontraumatic suture removal) and those of a continuous nylon suture (unimpaired wound healing, even adaptation).
Contact lens wear may be indicated for cosmetic, professional, optical or therapeutic reasons. For each of these indications the arguments are given, why and when contact lenses are better than spectacle correction and which possibilities there are. Contact lens wear is contraindicated in certain eye diseases and in the case of problems of handling and hygiene. The author's preferences concerning the different contact lens materials are summarized briefly.
The B scan sonographic characteristics of drusen of the optic disc are strong reflexion at low energy levels, shadowing in oblique and pseudobroadening of the optic nerve in orthograde beam direction. These signs provide additional security in differentiating deep drusen from a choked disc.
Report on local application of Cystin eye drops in a case of scleromalacia perforans. This medication brought the necrotizing disease process to a standstill. There was even discrete neoformation of scleral tissue, which we attribute to the collagenase inhibiting action of this drug.
Report on two patients whose symptoms suggested the presence of congenital achromatopsia. In one case there was indeed total colour blindness, but a normal photopic ERG. Here, achromatopsia is the present stage in a process of slow functional decay of the central retina. Most probably the underlying disorder is progressive foveal dystrophy, a central form of cone dystrophy. In the other case there was a nonrecordable photopic ERG, but trichromatic colour vision. This appears to be another patient with oligo-cone trichromasy (general cone dysfunction without achromatopsia), as described by Van Lith.
Soft hydrophilic contact lenses are widely favored thanks to their minimal ocular irritation. They may, however, also cause severe eye disease. In this report, allergies, hypoxia, tear film alterations, toxic effects and infections, as caused by soft lenses, are described, and their diagnosis, differential diagnosis and prophylaxis discussed. Moreover, it is pointed out that a misdiagnosis of "contact lens intolerance" may have serious consequences.
Inverse and regular occlusion therapy is carried out by means of a block coloured soft contact lens in cases, in which previous conventional patching had not been successful for external reasons. The technical data of the lens used and the indications for its application are given. Preliminary results show the usefulness of this method.
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The relevance of fungal contamination of soft contact lenses is demonstrated by own clinical observations in 25 cases. It can be shown by surface-microscopical, histological and mycological analysis, that various fungi can not only grow on the surface of HEMA-lenses, but can also invade the material. The efficacy of chemical disinfectants, as tested against two of the isolated fungi seems to be inferior to that of heat sterilisation. The resulting fundamentally and clinically important consequences, especially concerning permanent wear of hydrophilic contact lenses, are discussed.