Role of orthoptic exercises alone (without the aid of surgery) in the treatment of small angles of deviation.
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A series is presented of nine patients who demonstrate the heavy eye phenomenon. Illustrations of these patients show the salient features of the phenomenon, including hypotropia, exotropia and pseudoproptosis. The condition is summarized and the pathogenesis of the eye and lid positions are discussed. The indications for surgery and some examples with results are shown. The correct diagnosis may prevent unnecessary investigation of pseudoproptosis and pseudo third-nerve palsy.
We report on a case of early portal vein thrombosis occurring after liver transplantation in a patient with alcoholic cirrhosis. Although this complication is usually accompanied by acute graft failure and/or gastroesophageal bleeding, in this patient the portal thrombosis occurred with the appearance of general dropsy and encephalopathy, serum protein deficiency and a slight rise in liver function test values. Echo-Doppler and arteriography showed portal thrombosis, arterial hyperflow and the persistence of a large spontaneous spleno-renal shunt, identified before the transplant had taken place. Endoscopy did not reveal gastroesophageal varices. Since there was no sign of serious ischemic damage or of a serious deterioration of liver function, the patient was treated non-operatively. Some particular hemodynamic aspects implicated in the appearance of portal thrombosis in our case are discussed. However, the authors consider that spontaneous portal-systemic shunt, in the presence of advanced cirrhosis, inverted portal flow, without gastroesophageal varices, can be considered as a surgical total diverting shunt and should be taken as a risk for portal thrombosis after transplantation.
Stereoacuity levels regained after uniocular lens implantation for unilateral cataract are related to the final visual acuity of the operated eye. They compare unfavorably with levels reported in normal populations and are unrelated to the period of monocularity and the residual optical defects of the operated eyes. Using random dot stereograms as a criterion, over a third of thirty-five patients remained stereoblind after treatment.
The authors report a new case of cardiac sarcoma treated by cardiac transplantation. This treatment has been proposed for these malignant tumours of poor prognosis when simple excision is impossible, with variable results. This patient is in good general condition 20 months after transplantation. Transplantation is a therapeutic procedure which should be considered in malignant tumours limited to the heart.
Recent observations of about 4000 children within the age of two to seven years are reported. It seems to be very useful to do all examinations such as visual acuity, cover-test and stereo-test in familial surroundings by experienced investigators. A survey of visual acuity, squint and stereopsis of all children is given in detail as well as an outline of the consequences of this study to the public health welfare.