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PubMed1995

[Computer program for improved diagnostic coding in ophthalmology based on the expanded ICD 10].

BACKGROUND: The coding of ophthalmological diagnoses is a long-standing problem that has recently been highlighted by the planned introduction of ICD 10. METHODS: Using an alphanumerical classification system for the first time, ICD 10 offers the space needed for necessary expansion without leading once again to dislocations in the numbering system. The FoxPro 2.5 database system was used to create a program based on an expanded ICD 10 that can be applied from DOS and Windows. RESULTS: ICD 10 was expanded by the addition of a numerical fifth digit, thus increasing the number of classifiable ophthalmological disorders by a factor of 4.2 from 390 to 1635. The new program greatly facilitates the handling of this substantial amount of data. CONCLUSIONS: The enhanced diagnosis coding achieved with the expanded ICD 10 permits nosologically exact statistics to be kept for use as a basis for further scientific work.

Data Display↗
PubMed1993

[Ophthalmologic findings in graft versus host disease (GvHD)].

BACKGROUND: Since the era of bone marrow transplantation, the picture of acute and/or chronic transplant reaction of the host cells against grafted bone marrow has become more frequent. The so-called adaptive immune therapy bases on the fact that patients who present with a low grade of GvHD less often suffer from a relapse of the malignant leukaemic disease. Therefore, new therapeutic regimen are now performed which keep the patient on a low level of GvHD to prevent a recurrence of leukaemia. Here a close cooperation of oncologists and ophthalmologists becomes more and more important to estimate the stage of GvHD. PATIENTS: Demonstrating two case reports, we report on the ophthalmological symptoms of acute and chronic GvHD. Both patients presented with acute ocular GvHD as well as with signs of chronic ocular GvHD. Concerning the ophthalmological symptoms, in acute or chronic GvHD the conjunctival involvement is most important. There is a lymphocytic infiltration of the conjunctiva and of the lacrimal glands which leads to an extreme sicca-syndrome. The acute GvHD of the conjunctiva can be classified into 4 stages: injection/exudation and chemosis/formation of pseudomembranes/defects of the corneal epithelium. These stages correlate directly to the prognosis of the survival time of the patient. A pathognomonic sign for the chronic GvHD of the conjunctiva are the fibrous-scarry Arlt-lines of the tarsal conjunctiva. CONCLUSIONS: All patients who underwent a bone marrow transplantation for leukaemia need to be followed up closely to estimate the level of GvHD they are in. This applies especially to those patients who are treated according to the regimen of adaptive immune therapy. A close cooperation of oncologists and ophthalmologists during adaptive immune therapy is mandatory, as the ophthalmologist can provide important information to help to grade the level of GvHD, judging by the morphological picture at the slit lamp.

Adult↗
PubMed1988

[Visual disorders caused by diphenylhydantoin: clinical and electro-ophthalmologic findings].

In 1981 a 47-year-old white woman was given a total of 9 g of DPH for treatment of epilepsy. A rare hereditary defect in the metabolism of this drug caused toxic blood levels for about three months and led to persistent neurologic and ophthalmologic disturbances. In addition to an atrophy of the cerebellum, demonstrated by a CT scan, the predominant ophthalmologic findings were bilateral reduced visual acuity (0.1) and restricted visual fields (15 degrees). Despite intensive clinical and electrophysiologic investigations it proved impossible to localize the site of damage in the ascending visual pathway. Only VECP to patterns of low contrast (0.2) exhibited a pathologic response. It was concluded that persistent visual disturbances due to DPH intoxication are caused by a more centrally located action of this drug.

Electrooculography↗
PubMed1987

[A tracker for ophthalmology].

Real-time tracking of eye movements offers a solution to various problems in ophthalmology. Different types of image analysis and processing techniques is discussed and an advanced pattern recognition eye-tracking system has been developed; it can track a retinal target (in real time) under conditions typical for ophthalmologic examination and therapy. The sensor is a modified low-light video fundus camera. An example illustrates how a retinal target is automatically found again when it has been "lost".

Eye Movements↗
PubMed2000

Ophthalmologic complications after intraoral local anesthesia with articaine.

A series of 14 cases of ophthalmologic complications after intraoral anesthesia of the posterior superior alveolar nerve is presented. The most commonly encountered symptoms were diplopia, mydriasis, palpebral ptosis, and abduction difficulties of the affected eye. In all cases, these effects occurred a few minutes after injection of the anesthetic, followed by complete resolution without sequelae on cessation of the anesthetic effect. The pathogenic mechanism underlying such ophthalmologic disorders is discussed in terms of a possible diffusion of the anesthetic solution toward the orbital region.

Adult↗
PubMedDate not supplied

Epidemiological study of the systemic ophthalmological effects of carbon disulfide.

A total of 123 male viscose rayon workers who were exposed to carbon disulfide, and an additional 67 workers who were not exposed to any toxic agent in the working environment, underwent a thorough ophthalmological examination. The relationship between exposure and ophthalmological results was analyzed with univariate and multivariate methods. The most striking findings were strong associations between exposure and the 100-HUE color vision score and excess of microaneurysms in the exposed group. The current threshold limit value appeared to protect against these effects.

Adult↗
PubMed2001

Ophthalmologic, visceral, and cardiac involvement in neonates with candidemia.

A retrospective review of 86 neonates with candidemia hospitalized from January 1989 through June 1999 was conducted to determine the frequency of ophthalmologic, visceral, or cardiac involvement. Retinal abnormalities were observed in 4 (6%) of the 67 infants in whom indirect ophthalmoscopy examination was performed. Abdominal ultrasound abnormalities were detected in 5 (7.7%) of 65 infants. Echocardiogram revealed thrombi or vegetations in 11 (15.2%) of 72 infants. Age at onset, presence of central venous catheters, and species of Candida were not predictors for involvement at these sites. Infants with candidemia that lasted > or =5 days were more likely to demonstrate ophthalmologic, renal, or cardiac abnormalities than those with a shorter duration. Infants with involvement of these organs received larger cumulative doses of amphotericin B than those without detectable abnormalities. Because complication of disseminated candidiasis by eye, renal, or cardiac involvement has therapeutic implications, and because risk factors for candidemia inadequately predict these complications, evaluations are indicated for all neonates with candidemia.

Candida↗
PubMed2003

Ophthalmological and biological features of the oculorespiratory syndrome after influenza vaccination.

We report the ophthalmological and laboratory findings of 6 patients who, after influenza vaccination, were affected by oculorespiratory syndrome (ORS), complaining of red eyes, photophobia, blurred vision, palpebral edema, ocular pain and itching, and conjunctival secretions. The conjunctivae were mildly hyperemic with few follicles, but the ophthalmological examination findings were otherwise normal. Patients had lymphopenia and decreased levels of the total hemolytic complement and the third and fourth component of the complement. We conclude that ORS causes conjunctivitis and seems to involve the complement.

Adult↗
PubMed1984

Neuro-ophthalmology of sphenoid sinus carcinoma.

Three cases of sphenoid sinus carcinoma observed personally and 39 identified in the English language publications are reviewed. Sphenoid carcinoma constitutes only 0.3 per cent of sinus cancer. Its symptoms and signs are nonspecific until the sinus wall is penetrated. Once breached, specific neuro-ophthalmological symptoms and signs ensue, resulting from involvement of anatomically contiguous structures. These are characterized most commonly by the sphenocavernous syndrome and less frequently by isolated sixth nerve palsies and visual loss. Identified best by plain radiography, polytomography and computerized tomography, diagnosis of sphenoid carcinoma requires direct biopsy. Treatment, principally with radiotherapy supplemented by chemotherapy, has been disappointing with most patients dead by three years. The authors believe that in rapidly evolving neuro-ophthalmological syndromes of basal origin, accompanied by intractable headache, sphenoid sinus cancer must be considered.

Blepharoptosis↗
PubMed2002

Ophthalmologic sequelae of thermal burns over ten years at the Alfred Hospital.

PURPOSE: To study the ocular outcomes of facial burns over a 10-year period at the Alfred Hospital; in particular, to investigate the impact of 3 variables (grading of burn, use of prophylactic ocular surface lubrication, and timing of ophthalmologic referral) on the requirements for eyelid surgery. METHODS: A retrospective review of patients admitted to the Alfred Hospital (from October 1990 to October 2000) after thermal burns with facial, eyelid, and ocular involvement. RESULTS: Sixty-six patients were identified with facial burns involving the lids or eyes, having been admitted over a 10-year period. Of these 66, 7 died of complications of the burns and 12 required eye or eyelid surgery. Of those patients treated with prophylactic ocular surface lubrication, the rate of ocular surgery was 18.4% as opposed to 30% when no prophylaxis was used. The higher the percentage of total burn, the later the referral was made. Of those with severe eyelid burns, 100% had eyelid surgery and 50% of moderate burns had eyelid surgery. Sixty percent of moderate eyelid burns that required surgery did not receive prophylaxis. Thirty-four of 66 patients had acute corneal involvement, but only 3 eyes of 118 had long-term corneal morbidity. CONCLUSIONS: The requirement for eyelid surgery was closely related to the severity of the eyelid burn. The presence of an acute corneal burn with epithelial loss was not a poor prognosticator. The use of prophylactic ocular surface lubrication may provide early corneal protection, thereby minimizing ulceration in patients who may otherwise have required surgery, especially in those with mild to moderate exposure. Prompt ophthalmologic examination and the early use of prophylactic ocular surface lubrication for the cornea are associated with less need for eyelid surgery in patients with moderate eyelid burns.

Cornea↗
PubMed1999

Neuro-ophthalmology of diabetes.

The devastating, blinding effects of diabetic retinopathy have been well publicized. Although individually less common, many neuro-ophthalmologic complications are also associated with diabetes. The vascular effects of diabetes contribute to nonarteritic ischemic optic neuropathy, vasculopathic cranial neuropathies, and strokes affecting both afferent visual function and ocular motility. The neuropathic effects of diabetes primarily affect pupillary function, and the immunosuppressive effects of diabetes predispose to certain infections, such as mucormycosis. Diabetes is also associated with numerous congenital syndromes. This paper reviews the literature published in the past year on the neuro-ophthalmologic effects of diabetes.

Blindness↗
PubMed1998

Effects of short duration morning bright light in healthy elderly subjects. I: subjective feeling and ophthalmological examinations.

Seven aged subjects aged 61-78 years were exposed to 6000 lx bright light for 30 min during morning hours at their homes for 1 week. Visual analog scale was recorded before bedtime and after rising to assess subjective feelings. Ophthalmological examinations were made before and after light exposure, to exclude pre-existing ocular disorders and to detect ocular damage. Furthermore, ocular fatigue was self-evaluated immediately before and after exposure. Visual analog scale results indicated that alertness reduced significantly before bedtime. Ophthalmological abnormalities were not found after exposure. These findings suggest that short duration morning bright light exposure reduces night-time vigilance.

Aged↗
PubMed1988

Botulinum toxin in ophthalmology.

Alan B. Scott selected, researched and developed Type A Botulinum toxin for clinical use in ophthalmology. This unique drug has proved invaluable for treatment of a number of conditions which are difficult to treat in ophthalmology and in a variety of other disciplines. The indications, methods and problems of its use are described and the results of treatment of 133 patients are discussed. Up to December 1986 over 13,000 patients have been treated in a multicentre international trial without significant complications.

Aged↗
PubMed2005

Ophthalmological manifestations of Fabry disease: a survey of patients at the Royal Melbourne Fabry Disease Treatment Centre.

BACKGROUND: Fabry disease is a rare X-linked inborn error of glycosphingolipid metabolism. The aim of this study was to document the ophthalmological manifestations of patients attending the Royal Melbourne Hospital Fabry disease treatment centre. METHODS: Patients at the treatment centre had full ophthalmological examination performed. This included best corrected visual acuity, ocular motility examination and examination of the adnexae. Patients also underwent slit-lamp examination looking for the presence of features of Fabry disease, particularly examining the bulbar conjunctiva, cornea, lens and fundus. RESULTS: Thirty-four hemizygous male and 32 heterozygous female patients were recruited. The mean age of the hemizygous male patients was 37.7 years (range 18-57 years). The mean age of the heterozygous female patients was 34.6 years (range 1-78 years). Visual acuity was not affected. 97.1% of the hemizygotes and 78.1% of the heterozygotes had vascular abnormalities of the bulbar conjunctiva. Cornea verticillata was noted in 94.1% of the hemizygotes and 71.9% of the heterozygotes. 41.2% of the hemizygotes and 9.4% of the heterozygotes had anterior cataract formation. Posterior lens opacities were observed in 11.8% of the hemizygotes and none of the heterozygotes. Retinal vascular tortuosity was observed in 76.5% of the hemizygotes and 18.8% of the heterozygotes. CONCLUSION: Conjunctival vascular tortuosity was the most common manifestation in this series. Conjunctival and retinal vessel tortuosity, and corneal verticillata are frequently observed in Fabry disease. The incidence of lenticular changes is not consistently reported, but in this series and many others, it is much less common than that of corneal, conjunctival and retinal changes.

Adolescent↗
PubMed1978

Pituitary adenoma and visual function. The prognostic value of clinical, ophthalmological and neuroradiologic findings in 51 patients subjected to operation.

The series studied included 51 patients subjected to operation for pituitary adenoma. The visual status was analysed both pre- and postoperatively. The pre- and postoperative parameters were compared with clinical information, ophthalmological and neuroradiological findings with a view to an evaluation of their prognostic value. In 36 patients with chromophobe adenoma, visual field defects were present in 92% before the operation; visual function improved in 62% and returned to normal in 24%. Among 15 patients with eosinophil or mixed adenoma, only two (13%) had visual field defects pre-operatively. In those patients where operation was followed by a distinct visual improvement, the pre-operative ophthalmological findings were as follows: visual acuity greater than 6/24, normal optic discs, visual field defects up to two quadrants, and pneumoencephalographic findings suggestive of only a small suprasellar tumour.

Adenoma↗
PubMed1985

Contact allergy to components in topical ophthalmologic preparations.

Contact allergy to various components of topical ophthalmological preparations was tested in 27 patients suffering from prolonged or chronic conjunctivitis, keratoconjunctivitis or blepharoconjunctivitis. Our results reveal relevant allergy towards ophthalmological preparations in 44.4% of patients tested. Allergic reactions to topical antibiotics, especially to neomycin (18.5%) and bacitracin (7.4%) was encountered as well as allergy to preservatives such as benzalconium chloride (3.7%). It is essential to bear in mind that contact allergy to components of topical preparations may cause complications and prolongation of symptoms during treatment, and therefore the importance of performing patch tests in prolonged cases of conjunctivitis or keratoconjunctivitis is stressed.

Adolescent↗
PubMed2001

The measurement of three dimensional dose distribution of a ruthenium-106 ophthalmological applicator using magnetic resonance imaging of BANG polymer gels.

The BANG (MGS Research Inc., Guilford, CT) polymer gel has been used as a dosimeter to determine the three-dimensional (3D) dose distribution of a ruthenium-106 (Ru-106) ophthalmologic applicator. An eye phantom made of the BANG gel was irradiated with the Ru-106 source for up to 1 h. The phantom and a set of calibration vials were scanned simultaneously in a GE 1.5 T MR imager using the Hahn spin-echo pulse sequence with a TR of 2000 ms and two TEs of 20 ms and 100 ms. The T(2) values were evaluated on a pixel-by-pixel basis using custom-built software on a DEC alpha workstation and converted to dose using calibration data. Depth doses and isodose lines of the Ru-106 eye-plaque were generated. It is concluded that the BANG gel dosimetry offers the potential for measuring the 3D dose distributions of an ophthalmologic applicator, with high spatial resolution and relatively good accuracy.

Brachytherapy↗
PubMed2004

Ophthalmological manifestations in segmental neurofibromatosis type 1.

AIMS: To study the ophthalmological manifestations in individuals with the typical features of neurofibromatosis type 1 (NF1) circumscribed to one or more body segments, usually referred to as segmental NF1. METHODS: Visual acuity and colour tests, visual field examination, slit lamp biomicroscopy of the anterior segment, and a detailed examination of the retina by indirect ophthalmoscopy were performed at diagnosis and follow up in 72 consecutive subjects (29 males, 43 females; aged 1-64 years; mean age 14.6 years) seen at the university departments of paediatrics in Catania and Rome, Italy, during years 1990-2003, who had in restricted body areas: (1) typical pigmentary manifestations of NF1 (cafe au lait spots and freckling) only (n = 48); (2) NF1 pigmentary manifestations and neurofibromas alone (n = 2); (3) neurofibromas only (n = 15); and (4) plexiform neurofibromas only (n = 7). RESULTS: None of the 72 patients had Lisch nodules in the iris irrespective of age at eye examination or hypertelorism (a "minor" NF1 feature) and none developed typical associated ophthalmological NF1 complications. An additional child had an isolated optic pathways glioma (OPG), which behaved both biologically and radiographically as an NF1 associated OPG. CONCLUSIONS: This represents the first systematic study reporting on eye involvement in the largest series of individuals at different ages having segmental NF1. As one of the postulated mechanisms to explain segmental NF1 is somatic mosaicism for the NF1 gene (so far demonstrated only in two patients) the present findings could be explained either by the fact that the eye is too far from the mutated area with NF1 lesions in most cases or by the NF1 (or other "predisposing" or "cooperating") gene mutation restricted to too few cellular clones or to tissues embryologically different from the eye.

Adolescent↗