Use of a transparent film dressing to enhance compliance with occlusion therapy for amblyopia.
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Biomedical subjects
Publications and source records attributed to W T Parker.
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Sixty-six eyes of 66 patients undergoing planned extracapsular cataract extraction with interrupted 10-0 nylon suture wound closure were followed up prospectively for three years following surgery to evaluate the long-term evolution of postoperative astigmatism. The study examined the period beginning three months postoperatively, well after all suture cutting was completed, a point often considered to represent "final postoperative astigmatism." For the group as a whole, the induced astigmatism measured at three months was not stable, but gradually shifted 0.69 diopter toward against-the-rule astigmatism. Three specific patterns of evolution of postoperative astigmatism were identified, depending on the amount of induced astigmatism found at three months. The data revealed that it was not possible to consistently induce with-the-rule astigmatism, although permanent against-the-rule induced astigmatism could be produced. The long-term evolution of postoperative cataract wounds toward more against-the-rule astigmatism seen in this study was not affected by the number of intact nylon sutures. Proper evaluation of any technique to modify postoperative astigmatism must consider the long-term evolution of the cataract wound.
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A "marking suture" was used in 12 consecutive cases of adjustable strabismus surgery to determine the relationship between ocular alignment and the amount of horizontal muscle adjustment. The average change in ocular alignment was 2.55 prism diopters for each millimeter of muscle adjustment. Regression analysis revealed the relationship to be linear over the range of adjustments studied. The sensitivity of adjustment was the same whether the adjusted muscle was advanced or further recessed and whether the adjusted muscle was the medial rectus or the lateral rectus. No relationship was found between the distance of a recessed muscle from its normal insertion and the subsequent adjustment sensitivity of that muscle. This information, when used clinically in conjunction with a marking suture, can facilitate the adjustment phase of adjustable strabismus surgery.
Adhesions between the contacting surfaces of conjunctiva, Tenon's capsule, and muscle produce "tissue drag" which can complicate procedures with adjustable muscle sutures. The use of Healon is recommended to minimize this tissue drag and facilitate the "adjustment phase" of muscle surgery with adjustable muscle sutures. Data on 14 consecutive cases demonstrate the utility of Healon in adjustable strabismus surgery.
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A 53-year-old woman developed night blindness 9 years after jejunoileal bypass surgery. Abnormal rod function was confirmed by dark-adapted electroretinography, and vitamin A deficiency was confirmed by low serum levels of vitamin A and carotene. Administration of oral vitamin A supplementation resulted in complete resolution of the patient's symptom and return of the electroretinogram to normal. Based on this case and the four previously reported cases, we suggest that jejunoileal bypass patients be routinely questioned about decreased night vision. Patients with this complaint should undergo thorough ophthalmic evaluation. Dark-adapted electroretinography or dark adaptation testing should be done to establish the presence of abnormal rod function, and serum levels of vitamin A or carotene should be obtained to identify the cause. It is important to identify vitamin A-deficient patients because of their potential to develop permanent impairment of night vision.
A case of bilateral keratoconjunctivitis caused by self-instillation of a 1% aqueous solution of gentian violet was complicated by a secondary uveitis and gram-negative conjunctivitis. The patient was treated with cycloplegics and specific antibiotics and after resolution of the bacterial infection, a mild topical corticosteroid was used. After six months the patient had completely recovered from the keratitis, but bilateral corneal vascularization, had unilateral posterior synechiae, corneal scarring, and cataract formation were present. Cationic dyes such as gentian violet appear to be toxic to the ocular surfaces and tend to produce severe intraocular inflammation.
A group education program was developed for clinic patients with rheumatoid arthritis. Teaching methods used included the Arthritis Foundation's handbook, Rheumatoid Arthritis, and a lecture by a rheumatologist. The 20 patients in the study were given a multiple choice test before and after the teaching program to determine their knowledge of arthritis. Results showed group education to be an effective teaching device. It was demonstrated that patients learned from reading the handbook alone, but the combination of reading and lecture was found to be a more effective method. Correlation studies showed that prior to group education, patients had a significant knowledge of their disease which was related to native intelligence, formal education, and socio-economic status, but not to duration of disease or length of clinic attendance. This suggests that future patient education experiments should include a pre-instruction test to document prior knowledge.