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At least 757 records · Page 42Linked to original sources
PubMed1977

Management of cataracts in infancy and childhood.

In recent years there has been a considerable improvement in our understanding of the mechanism of stimulus deprivation amblyopia and a continuous development of better surgical techniques for the removal of cataracts in very young patients. In spite of these advances and the fact that modern constant wear soft contact lenses are now a reliable proposition, there has not been a parallel improvement in the visual results achieved after cataract extraction and aphakia continues to present considerable problems of management in children. This study analyses over 100 cases treated at Moorfields Eye Hospital in recent years. As a result of our findings a Paediatric Aphakia Service has been established in order to integrate the surgical, contact lens, and orthoptic care of these patients.

Age Factors↗
PubMed1988

[Early evaluation of the vision of infants: baby vision, a reality today].

Non invasive techniques such as preferential looking, Teller acuity cards and orthoptic examination allow an early detection and treatment of visual defect. As early as 3 months of age, the pediatrician should refer to an ophthalmologist any child at risk on the ground of its personal or family history. Visual evoked potentials and retinography should be used in the case of more severe problems.

Electronystagmography↗
PubMed1988

Accommodative spasm: a study of 17 cases.

Accommodative spasm (AS) is rarely reported in the literature. We studied 17 patients with accommodative spasm. Most patients were clinically emmetropic. Ten patients also manifested a spasm of the near reflex (SNR). The probable etiology of the accommodative disorder for most patients was psychogenic as revealed by case histories and visual field analysis. Treatment consisted primarily of plus reading lenses and, in some instances, orthoptic training. Some patients also underwent psychological counseling. Follow-up ranged from 2 months to 30 months. Although visual symptoms improved for most patients, only four patients had complete resolution of the spasm.

Accommodation, Ocular↗
PubMed1987

Injection of type A botulinum toxin into extraocular muscles for correction of strabismus.

Between July 1984 and March 1985, 51 injections of type A botulinum toxin were given to 39 patients aged 11 to 81 years with various types of strabismus, including paralytic strabismus, sensory exotropia, consecutive and residual postsurgical deviations and partially accommodative esotropia. All deviations were documented by orthoptic assessment and photography. After treatment the patients were followed for up to 3 years. The beneficial effects of a single injection were modest, and a second injection was often necessary to achieve satisfactory ocular alignment. Thirteen of the 26 patients (50%) with nonparalytic strabismus and 10 of the 13 patients (77%) with paralytic strabismus had a good outcome (final deviation 12 prism dioptres or less). Adverse side effects included transient ptosis and diplopia and inadvertent vertical deviation. Twenty-one consecutive cases of nonparalytic horizontal strabismus treated with adjustable sutures were also reviewed. The results in these patients were more predictable and longer lasting than those in the patients who received botulinum toxin.

Adolescent↗
PubMed1985

Pattern ERG in amblyopia.

The authors have recorded pattern ERGs in 62 amblyopic children. In 12 who were occluded up until the morning of the test, the occluded eye response was reduced, and the ratio ([response amplitude of amblyopic eye]/[response amplitude of fellow eye]) was greater than unity. In the remainder, the ratio was considerably less than unity. Ratios of less than 1.0 were found for anisometropic, esotropic, exotropic, and microtropic amblyopes. The ratio was not related to visual acuity or to squint but was higher in those children whose vision was improved by orthoptic treatment. In a group of older children recalled to the clinic, the ratio was 1.0 in those who had maintained equal visual acuity and was less than unity in those children whose acuity had regressed after treatment, or had not improved during treatment. The reduction of the pattern ERG in amblyopes occurs without a corresponding reduction in the focal ERG. In adult amblyopes, the relationship between loss of acuity, loss of grating contrast sensitivity, and the reduction in the PERG is complex and may differ according to the type of amblyopia.

Adolescent↗
PubMed1985

[Operation indications of blow-out and midface fractures].

89 patients with fractures of the orbital floor - both in isolation (blow-out fractures) and combined with a complex fracture of the midregion of the face - were followed up for an average of 5 years. Particular attention was paid to the quantitative evaluation of binocular fusion, diplopia and enophthalmos. Comparison of operated and conservatively treated patients with blow-out fractures led to the following conclusions with regard to indications for surgery: 1. It is not justified to regard either surgery or its postponement pending developments as obligatory in all cases. 2. Surgery is indicated by clinical, orthoptic and roentgenological findings as follows: a) In case of enophthalmos or roentgenological demonstration of prolapse, surgery is indicated independent of diplopia. b) Diplopia outside the main field of view does not, in general, necessitate surgery. c) If there is diplopia within the main field of view, surgery is indicated. It is generally accepted that orbital-floor fractures associated with complex mid-face fractures require early surgical treatment. The present investigation confirms this view.

Convergence, Ocular↗
PubMed1979

[Strabismus in cerebral paretic and normal children. Comparison of motoric symptoms (author's transl)].

Investigations of 94 children with cerebral palsies have shown 55% strabismus incidence. Motoric symptoms like varying angles, nystagmus (latens), A-V phenomena, dissociated hypertropia and compulsive head postures are presented, frequently more often than in a number of comparison cases of undamaged squinting children. However, these symptoms have not permanently been found even in severly damaged children. With the exception of compulsive head postures, no symptoms are found in strabismus cases of cerebral paretic children that do not occur in congenital strabismus patients as well. A frequent family heredity strain of strabismus has also been noted. There is a striking proportion of divergence cases (27%). The authors do not believe in a simple damaging etiology. Pleoptic-orthoptic exercises are hardly ever practicable. Early operation may improve the initial situation as far as the neuropediatric therapy is concerned.

Adolescent↗
PubMed1979

After-image transfer--evaluation of short-term treatment.

The records of treatment by the after-image transfer method of 21 children, mainly with strabismus amblyopia, were examined to evaluate the acuity improvement in the short term. There was no significant improvement in 15 cases. In several other patients, an immediate response to the after-image method occurred, but these patients' binocular vision and acuity had deteriorated following previous improvement achieved by other orthoptic methods.

Adolescent↗
PubMed1978

[Diagnosis and treatment of eye muscle palsies (author's transl)].

After the discussion of the clinical symptomatology of paralytic squint (diplopia, variable angle of squint, compensatory head posture etc.) the importance of modern electromyography for differentiation between myopathy (affection of the eye muscles), myastherias (affection of the neuromuscular transmission) and peripheral neurogenic palsies (affection of the peripheral neuron up to the nuclear region) is discussed. The clinical symptomatology of these affections of different levels is discussed as well as the differential diagnosis. The treatment of eye muscle palsies in principle consists in: 1. medical treatment (local and general), 2. optical treatment (glasses, occlusions, prisms etc.), 3. orthoptic treatment, 4. surgical treatment.

Blepharoptosis↗
PubMed1978

[Disturbances of fusion after extensive retinal haemorrhages in new-born infants (author's transl)].

Follow-up examinations of 21 non-squinting children aged six revealed, that most children who had had extensive bilateral post-partum retinal hemorrhages had a significantly higher incidence of impaired range of fusion (25 degrees max.) as compared to the cases without perinatal hemorrhages. Not a single case of impaired fusion could be improved by orthoptic treatment. The disorder is assumed to be due to a discrete perinatal impairment of the cerebral optomotor centers.

Age Factors↗
PubMed1984

Visual problems in children: detection and referral.

A study was made of 151 children referred to orthoptic clinics for suspected squint or suspected impairment of visual acuity. In only 50 children was there no abnormality. The contribution of different branches of the health service to detection and referral was measured. Parents and general practitioners were found to have an important role in early detection and referral, but there remained an important group of 19 children with squints undetected by their parents.There was some evidence of delay in referral, with less than half of the children with true squint being seen by a specialist within six months, and the reasons for this are discussed in terms of parents' and doctors' understanding of visual problems in children. Delay is discussed in relation to the complexity of services for child health and to recent proposals for the integration of paediatric surveillance in general practice.

Amblyopia↗
PubMed1981

On the origin of visual dyslexia.

Analysis of the binocular co-ordination errors of a young dyslexic reveals a simple optical explantation for one of two types of letter confusion found in dyslexia. Although binocular control was grossly abnormal in reading, no ocular defect could be found in standard ophthalmic and orthoptic tests. Re-examination of the same patient six years later, again showed no ocular defect on normal testing but binocular movements in reading, while still abnormal, showed no trace of the striking original defect. This complete masking of the original condition with time must severely restrict the value of mass surveys of established dyslexics.

Adolescent↗
PubMed1995

[Motility disorders in brachytherapy of choroid melanomas with Ru106 applicators].

Accurate visualization of the tumor base by diaphanoscopy is essential for optimal placement of a ruthenium plaque. Depending on the localization of the tumor, dissection of one or more of the rectus muscles is necessary during placement of the plaque or during the course of protracted irradiation. Orthoptic investigations were performed to evaluate the cause of motility disorders and to follow up the functional outcome. In 13 patients (out of 30) who underwent ruthenium-106 therapy for uveal melanomas, one or more muscles had to be dissected during placement of the plaque and were reinserted in the same operation or after removal of the applicator. In 4 cases rectus muscles had to be shifted and were replaced after the irradiation. There were 5 patients who developed motility disorders with double vision. All of them were orthophoric within 6 months without surgery.

Adult↗
PubMedDate not supplied

[Arterial and biliary complications of hepatic transplantation].

Despite progress in standardization of reconstruction procedures, arterial and biliary complications remain an important problem in liver transplantation. These complications directly affect graft survival and patient mortality. We review a series of 165 consecutive orthoptic liver transplantations performed in 146 patients including 3 children. Biliary reconstruction included bilio-biliary termino-terminal anastomosis in 88% of the cases and bilio-digestive choledoco-jejunal anastomosis in 12%. Biliary complications occurred in 15% (25/165) with more obstruction (64%, 16/25) than leakages (64%, 7/25); 28% (7/25) of these complications were related to biliary drainage (3 obstructions and 4 leakages). There were no arterial complications in the 7 patients with non-anastomotic biliary stenosis. The rate of arterial complications was 11%; with 8 stenoses, 5 thrombosis and 5 pseudoaneurysms. Among the 18 transplantations with an arterial complication, 7 (39%) also had a biliary complication. Among the 10 patients with a complete interruption of arterial blood flow (thrombosis or surgical ligature or a ruptured pseudo-aneurysm), 5 (50%) also had a biliary complication, 1 underwent early retransplantation and 2 died early. In conclusion, the biliary tree of the graft are particularly susceptible to interrupted arterial flow. Ischaemic biliary lesions predominate in the intra-hepatic biliary ducts. Biliary drainage is important.

Adolescent↗
PubMed1995

Nonaccommodative factors of refractive accommodative esotropia.

The clinical characteristics of 45 cases of refractive accommodative esotropia were compared with 31 cases of the control group who remained orthotropic in the presence of uncorrected same degree of hypermetropia. In addition to the general ophthalmologic and orthoptic examinations, the accommodative convergence/accommodation (AC/A) ratio, fusional vergences and random dot stereopsis were investigated. The hypermetropic patients without esotropia were found to have a lower AC/A ratio and normal fusional function, while in cases with refractive accommodative esotropia, their AC/A ratios were normal and their fusional functions were decreased, especially significant being the divergent fusional function. In both groups, their stereopsis was defective or absent. It is suggested that esotropia be not simply caused by excessive accommodation due to uncorrected hypermetropia, and the range of divergent fusional function and the level of AC/A ratio be the two factors which determine the causation of esotropia in cases with uncorrected hypermetropia.

Accommodation, Ocular↗
PubMed1994

Iatrogenic lateral rectus palsies. A series of five postmyelographic cases.

The objective of this study was to assess the etiology of lateral rectus palsies in patients undergoing lumbar myelograms with Iopamidol (Isovue; ER Squibb and Sons, Princeton, NJ, USA; Niopam, E Merc, UK.). An audit of the departmental orthoptic record revealed two patients who had suffered abducens palsies after myelograms. A further search revealed three additional patients who had suffered similar complications. The incidence of abducens palsy in patients undergoing myelography with the contrast agent Iopamidol was found to be 1 in 500 in around 2,500 myelograms performed under standard conditions. It would appear that lateral rectus palsy in myelography is the result of the lumbar puncture, the neurotoxic effect of the contrast agent, or a combination of the two in patients with an already compromised neurophysiologic state. This is the first series to associate this problem with Iopamidol. Although usually a serious neurologic symptom, when associated with contrast myelography using Iopamidol it is important to appreciate that such symptoms usually resolve of their own accord.

Abducens Nerve↗
PubMed1995

Large sample population age norms for visual acuities obtained with Vistech-Teller Acuity Cards.

PURPOSE: To determine population age norms in the first three years of life for binocular and monocular grating visual acuity (VA) obtained with Vistech-Teller Acuity Cards (TAC). METHODS: TAC was used to estimate grating acuity in 646 healthy infants and children born at due date +/- 2 weeks, all of whom underwent ophthalmologic and orthoptic evaluation. The sample consisted of 20 age groups from 0 to 36 months. Sixty-nine percent of the children attended day care centers in the city of São Paulo. The sample was composed of white (63.0%), mulatto (25.2%), African-Brazilian (11.0%), and Asian (0.8%) infants and children, most of whom (97%) were from low-income families. Tests were conducted by eight highly trained testers, six of whom were orthoptists. RESULTS: Binocular and monocular norms for grating VA are presented in terms of tolerance limits for 90% of the population with 95% probability. The range of tolerance limits is approximately 2.5 octaves at most ages. There were no statistical differences among scores obtained by the different testers. There were no differences in VA due to race, sex, and first or second eye tested. The results on binocular (99.3%) and monocular (96.2%) testability and on mean test duration (13 minutes for one binocular and two monocular measurements) confirm the clinical applicability of TAC. CONCLUSIONS: The binocular and monocular grating VA norms obtained in this large-sample study are different from the preliminary norms published with the TAC. Results from this and other studies (see Mayer et al, page 671, this issue) strongly point to a need for redefinition of the preliminary VA norms.

Aging↗