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Results for “Pupil Disorders”

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At least 469 records · Page 26Linked to original sources
PubMed1991

Assessing the comatose patient in the intensive care unit.

Consciousness is a complex phenomenon comprising arousal and awareness. These functions are mediated by the reticular activating system that begins in the brainstem and projects to higher cortical structures. Abnormalities directly or indirectly affecting this system may produce coma. Detailed neurologic assessment consists of evaluation of history, skeletal motor response, pupillary size and reactivity, eye movement, and respiratory patterns. Information obtained may be useful in localizing the contributory lesion, predicting outcome, and determining brain death. Several scales have been used to quantify coma, each with limitations. In the United States, the most widely used scale is the Glasgow Coma Scale.

Coma↗
PubMed2005

Role of early radial optic neurotomy in central retinal vein occlusion.

PURPOSE: To determine safety, clinical and visual results, and potential complications of early radial optic neurotomy (RON) surgery in eyes with central retinal vein occlusion (CRVO), with relative afferent pupillary defect and visual acuity MATERIALS AND METHODS: This prospective, interventional case-series included 24 patients of CRVO who underwent RON within 2 months of disease onset. The preoperative examination included slitlamp biomicroscopy, fundus photography and fluorescein angiography. Foveal thickness was measured using optical coherence tomography (OCT) in the last 6 eyes only. In each case, RON was performed after informed consent. Two radial incisions were placed in the nasal quadrant of the optic disc, using a micro-vitreoretinal blade. The postoperative change in vision, clinical picture, fundus photographs, angiograms and foveal thickness by OCT were the main outcome variables studied. The Wilcoxan signed test was used to assess the results. RESULTS: Average symptom duration was 37.8 +/- 15.2 days (range 15-60 days, median: 34.5 days) and follow-up 7.7 +/- 2.1 months (range 1-12 months, median: 8 months). Visual outcome: 2 (8.33%) eyes each had fall and preservation of pre-RON visual acuity respectively. Twenty eyes (83.33%) showed increase in vision (of average 3 lines). Pre and postoperative vision ranged from 0.017-0.1 (average:0.061) and 0.017-0.667 (average: 0.17) respectively (P < 0.05). Clinical and angiographic outcome: decline in macular oedema, decreased or resolved intraretinal haemorrhages, resolution of venous dilatation and disc oedema could be appreciated in all cases. Foveal thickness: average pre and postoperative foveal thickness was 834.17 microm and 556.17 microm respectively (P < 0.05) in the 6 eyes where it was measured before and after RON. One eye developed retinal-detachment. CONCLUSION: Radial optic neurotomy is better than the natural course in eyes with CRVO, with vision < 6/60.

Adult↗
PubMed2006

Pupillary-iris-lens membrane with goniodysgenesis: a case report.

We describe a rare case of pupillary-iris-lens membrane with goniodysgenesis, a unilateral neurocristopathy. The membrane represents ectopic iris on the lens with abnormal iris stroma and anterior chamber angle from aberrant induction, migration or regression of neural crest cells. The membrane can be progressive. Catastrophic vision loss from angle closure can occur and may be controlled with surgery. This subject needed treatment for amblyopia.

Abnormalities, Multiple↗
PubMed1997

[Macular light sensitivity and afferent pupillary function in children's amblyopia].

OBJECTIVE: To study the characteristics of macular light sensitivity (MLS) and relative afferent pupillary defect (RAPD) in anisometropic and ametropic amblyopia in school-aged children. METHODS: By using the static perimetry technique and swinging light test, we assessed MLS and RAPD in normal subjects, anisometropic and ametropic amblyopia in school-aged children. RESULTS: In comparison with the normal group, the MLS in both anisometropic and ametropic amblyopic eyes was significantly depressed. The MLS of the fellow eyes of the amblyopic eyes in anisometropic subjects was also depressed as compared with that of the normal group. The rate of RAPD was positive in 34.29% in the anisometropic amblyopic group. CONCLUSIONS: The static perimetry technique demonstrates a marked depression of MLS in all amblyopic eyes tested, suggesting a defect of visual X-channel. The pathogenesis of monocular amblyopia and binocular amblyopia is probably different, thus MLS examination can help assess prognosis. RAPD in anisometropic amblyopia may reflect a deficiency of peripheral visual system. The fellow eye of the anisometropic amblyopia eye may also be abnormal in terms of psychophysical standard.

Afferent Pathways↗
PubMed1999

Comparing pupil function with visual function in patients with Leber's hereditary optic neuropathy.

PURPOSE: To compare pupil function with visual function in patients with Leber's hereditary optic neuropathy (LHON) and age-matched normal control subjects. METHODS: Visual function was assessed by measuring the perceptual thresholds at five central locations in the visual field using automated static perimetry. Pupil function was assessed by recording the pupil responses to a standard intensity light stimulus (size equivalent to a Goldmann V target) presented at the same five locations in the visual field. The extent of the pupil afferent defect in LHON patients was quantified by establishing the relationship between stimulus intensity and the size of the pupil response in normal subjects and then interpolating the equivalent luminance deficit in LHON patients from the size of their pupil responses. RESULTS: At all five locations tested, the pupil responses were significantly reduced in amplitude, and the perceptual thresholds were significantly raised in LHON patients compared with normal control subjects. A nonparametric analysis of perceptual and pupil responses to perithreshold stimuli showed that a stimulus that was not perceived was three times more likely to be followed by a pupil response in a LHON patient than in a normal subject (P < 0.001). A quantitative comparison showed that the visual deficits exceeded the pupil deficits by on average 7.5 dB at all tested locations. CONCLUSIONS: Although both visual and pupil function are abnormal in LHON, there appears to be relative sparing of the pupil afferent fibers.

Adult↗
PubMed2000

Afferent pupillary defect associated with optic nerve head drusen.

BACKGROUND: Optic nerve head drusen (ONHD) are a relatively uncommon finding with an estimated prevalence of anywhere from 0.3% to 2%. Reports of relative afferent pupillary defects (RAPDs) associated with ONHD are scarce. CASE REPORT: A patient with an RAPD was found to have ONHD as the only apparent etiology of the RAPD. The various diagnostic tests relevant to the case, the differential diagnosis, and the pathological features of ONHD are discussed. CONCLUSIONS: It is important for the clinician to consider an RAPD as a possible pathological feature of ONHD--especially with an asymmetric presentation.

Aged↗
PubMedDate not supplied

Endophthalmitis after cataract surgery in eyes with small pupils managed by sector iridectomy and polypropylene suture closure.

Two patients with small pupils developed endophthalmitis following cataract surgery during which the small pupils were managed by sector iridectomy and closed with a polypropylene suture. Prior studies have reported that implantation of intraocular lenses (IOLs) with haptics made of polypropylene is associated with a higher risk of postoperative endophthalmitis than the use of IOLs with polymethylmethacrylate haptics. Endophthalmitis in the two patients reported herein was managed successfully without removal of the polypropylene suture; vision returned to 20/60 in one patient and 20/30 in the other patient. Iris retractors may represent a faster and safer alternative management option for small pupils than sector iridectomy closed with a polypropylene suture.

Aged↗
PubMed2001

Tissue cadmium and locomotor behavior following acute inhalation exposure to cadmium aerosol in rats.

Rats were exposed for 1 h to increasing concentrations of cadmium (Cd) through inhalation of cadmium chloride aerosol using nose-only inhalation chambers and depositions of Cd in lungs, liver and kidneys were measured. Changes in spontaneous locomotor activities were recorded 2 and 7 d after cessation of exposure. A concentration dependent increase in Cd in lungs, liver and kidneys was accompanied by significant alterations in spontaneous locomotor response that was dependent on the air Cd concentrations and the postexposure duration. The study shows decreased spontaneous locomotor activity due to Cd accumulation in tissues.

Administration, Inhalation↗
PubMed2001

[Intracameral suturing technique using the Kawano cannula].

BACKGROUND: Intracameral suturing procedures are often so difficult that new techniques need to be devised. CASE: A case of photophobia caused by the pupillary distortion after anterior chamber lens implantation in cataract surgery with vitreous loss. METHODS AND RESULTS: In contrast to use of the healon cannula, pupilloplasty was more easily and safely performed using the Kawano irrigation cannula (M-91, Inami, Tokyo) by supporting and/or pressing the iris with the wide, flat distal end of the instrument, and also by inserting the needle end into the cannula through the large created port. CONCLUSION: The Kawano irrigation cannula is a safe and useful tool in intraocular suturing procedures.

Aged↗
PubMed2001

Involvement of the peripheral nervous system in primary Sjögren's syndrome.

BACKGROUND: Involvement of the peripheral nervous system in patients with primary Sjögren's syndrome (SS) has been reported, but its prevalence in neurologically asymptomatic patients is not well known. OBJECTIVE: To assess clinical and neurophysiological features of the peripheral nervous system in patients with primary SS. PATIENTS AND METHODS: 39 (38 female) consecutive patients with primary SS, aged 20-81 years (mean 50), with a disease duration of 1-30 years (mean 8) were studied. The peripheral nervous system was evaluated by a questionnaire, physical examination, quantified sensory neurological examination, and neurophysiological measurements (nerve conduction studies). To assess autonomic cardiovascular function an orthostatic challenge test, a Valsalva manoeuvre, a forced respiration test, and pupillography were done. RESULTS: Abnormalities as indicated in the questionnaire were found in 8/39 (21%) patients, while an abnormal neurological examination was found in 7/39 (18%) patients. Abnormalities in quantified sensory neurological examination were found in 22/38 (58%) patients. In 9/39 (23%) patients, neurophysiological signs compatible with a sensory polyneuropathy were found. No differences were found in the autonomic test results, disease duration, serological parameters, or erythrocyte sedimentation rate between the patients with primary SS with and those without evidence of peripheral nervous involvement. CONCLUSION: Subclinical abnormalities of the peripheral nervous system may occur in patients with primary SS selected from a department of rheumatology, but clinically relevant involvement of the peripheral nervous system in this patient group is rare.

Adult↗