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At least 793 records · Page 44Linked to original sources
PubMed1988

Trabeculectomy, ECCE with PC-IOL implant, and vitrectomy after malignant glaucoma.

A patient with narrow-angle glaucoma developed a post peripheral iridectomy malignant glaucoma in both eyes. The intraocular pressure (IOP) in both eyes was controlled with mydriatics, cycloplegics, and Diamox for 2 years. Subsequently the patient developed a dense cataract and uncontrollable IOP in her left eye. An extracapsular cataract extraction, posterior chamber lens implant, and trabeculectomy were combined with an anterior vitrectomy. The IOP in both eyes has been controlled for 3 years postoperatively.

Aged↗
PubMed1988

Acute acquired comitant esotropia simulating late onset accommodative esotropia.

Acute acquired comitant esotropia in the older child, adolescent, and young adult may represent uncorrected accommodative esotropia. Three young patients developed spontaneous diplopia associated with acute comitant esotropia. In all cases, cycloplegic refraction revealed high uncorrected hyperopia suggesting late onset accommodative esotropia. However, for one patient an intracranial neoplasm precipitated the strabismus and for the other patients the hyperopic correction did not alter the deviation. Clinicians confronted with older children or adolescent patients with acute comitant esotropia associated with large uncorrected hyperopia should not hastily classify the deviation as being accommodative in etiology. Although the latter is possible, the hyperopia may be coincidental and masking an underlying mechanism.

Accommodation, Ocular↗
PubMed1986

Progressive hyperopia in radial keratotomy. Long-term follow-up of diamond-knife and metal-blade series.

In an earlier report, the authors demonstrated a trend toward progressive hyperopia in radial keratotomy (RK) patients examined between one and three to four years postoperatively. In those 109 cases, the surgeries were performed using a metal-blade instrument. In the following study, the metal-blade series was updated to a total of 225 procedures, and a more recent series of 300 procedures performed on 228 patients was examined in which a diamond-knife cutting instrument was used. Patients had uncorrected visual acuity determination, cycloplegic refractions with best corrected visual acuity measurements and keratometry measurements. The authors demonstrated a hyperopic shift in the distribution of postoperative spherical equivalent (SE) values across time such that higher proportions of cases in both metal-blade and diamond-knife series were at least 1.0 diopter (D) away from emmetropia at 24 and 48 months than was the case at 12 months after surgery. Regression analysis determined that none of the preoperative or surgical variables known to affect refractive outcome of RK (alone or in combination) could account for the changes in refraction seen during the course of postoperative time. In general, changes in keratometry paralleled refractive changes, but were somewhat smaller in magnitude.

Cornea↗
PubMed1987

Effects of dimethyl sulfoxide on a model of corneal alkali injury.

The potential role of dimethyl sulfoxide in minimizing early structural damage to the eye following corneal alkali injury was examined. Corneal alkali injury was induced in rabbits and treated with topical applications of 20% dimethyl sulfoxide. At day 3 the rates of corneal opacification (p less than 0.01) and corneal ulceration (p less than 0.05) were significantly lower in the treatment group than in the control group, but this effect was not sustained during the rest of the study period. Further work is required to determine the therapeutic value of topical dimethyl sulfoxide in combination with other agents, such as cycloplegics, corticosteroids, ascorbic acid and citric acid, in corneal alkali injury.

Alkalies↗
PubMed1986

Cardiac dysrhythmias associated with ophthalmic atropine.

Atropine sulfate, a mydriatic and cycloplegic agent, is frequently used in patients undergoing glaucoma surgery. Trabeculectomy with peripheral iridectomy is the most common glaucoma surgery performed to decrease intraocular pressure and preserve vision. Systemic absorption of ophthalmic atropine does occur and may result in toxic and adverse side effects. Cardiac dysrhythmias are one of the major adverse reactions. This case study reviews three patients who had a trabeculectomy for glaucoma and received ophthalmic atropine. One patient received both systemic and ocular atropine. Two patients developed atrial fibrillation and one a supraventricular tachycardia. Two patients required admission to a cardiac intensive care unit for management of the dysrhythmia and a third reverted to normal sinus rhythm spontaneously. The cardiac effects of ophthalmic atropine should be considered in the preoperative and postoperative assessment of patients with dysrhythmias.

Absorption↗
PubMed1979

[Herpes simplex virus isolations from the aqueous humor of patients suffering from focal iritis, endotheliitis, and prolonged disciform keratitis with glaucoma (author's transl)].

Aqueous humor from 33 herpes patients, 4 zoster patients, and 14 patients with etiologically unclear anterior uveitis was cultured for the presence of herpes viruses. Nine taps from 8 herpes patients with corneal endothelial disease and/or anterior uveitis yielded herpes simplex virus. In the case of one patient two taps were positive at 14 days' interval. Control cultures from the surface of conjunctiva and cornea were consistently virus-negative. Analysis of the virus-positive cases displayed three remarkable features: 1. Secondary glaucoma was uniformly present. This in itself is an indication for culturable herpes simplex virus in the aqueous. 2. Three clinical pictures could be differentiated biomicroscopically: focal iritis, peripheral endotheliitis, and prolonged disciform keratitis. 3. In a proportion of cases, tissue damage resulting from associated immune reactions seems to be more important for the functional outcome than tissue damage by viral cytolysis itself. After having tried several antiviral substances (trifluorothymidine topically, adeninearabinoside-monophosphate intravenously, human leukocyte interferon intramuscularly and intracamerally) we presently favour a topical combination therapy consisting of trifluorothymidine and steroids. This must be complemented by cycloplegics and--in cases of high intraocular pressure--by acetazolamide.

Adolescent↗
PubMed1979

[Cycloplegia with cyclopentolate for testing-refraction of children (author's transl)].

A comparative study of the cycloplegic effect of 1% cyclopentolate and atropine or homatropine was done by means of Lindner's method of retinoscopy. In 53% of 1.5- to 6-year-old strabismic patients the hypermetropic refraction was higher (average 0.6 dpt) under the use of atropine, and in 27% of 6- to 11-year-old children cyclopentolate was more effective than homatropine (average 0.5 dpt). Therefore, atropine should be used for children with convergent squint up to 6 years, in order to get full correction of hypermetropia. In other cases cyclopentolate is preferable because of its rapid and strong efficiency of brief duration.

Accommodation, Ocular↗
PubMed1981

Clinical pharmacokinetics of the eye. Proctor lecture.

Pharmacokinetics of instilled drugs in the human eye is reviewed. The behavior of drugs in the conjunctival cul-de-sac is discussed, and the loss rates with various vehicles are estimated. Kinetics of intraocular drug penetration follows the same pattern in human and rabbit eyes. From results of rabbit experiments, various pharmacokinetic coefficients are computed, including the permeability of the corneal epithelium. Also, with use of published data in human aqueous, the corneal permeability, apparent absorption, and elimination rate constants are calculated for some drugs in the human eye. From the anesthetic response of the cornea the apparent elimination rate constants of the surface anesthetics are obtained. The pupil response is converted to a response parameter proportional to the biophase drug concentration. The time course of its changes conforms with the kinetics of intraocular drug penetration, and the apparent absorption and elimination rate constants are computed for various drugs. The latter constant becomes smaller with increased ocular pigmentation. Use of the relative bioavailability concept permits comparison of drug absorption efficiency among various vehicles. Pharmacokinetic coefficients are also obtained for the cycloplegic responses. The intraocular pressure response is analyzed, and it is suggested that the reduction ratio in the outflow pressure, outflow resistance, and the aqueous formation rate be used for dose-response studies. The rate of effect disappearance is defined and is given for three beta-adrenergic blocking agents.

Adrenergic beta-Antagonists↗
PubMed1983

Transient retinal striae.

Transient retinal folding was observed in a 28-year-old woman presenting with bilateral uveal inflammation. These retinal striae resolved within 5 weeks as the anterior uveal inflammation responded to topical cycloplegic and corticosteroid therapy. Ultrasonographic findings demonstrated choroidal thickening as a contributing factor in the production of these temporary retinal folds. We present this unusual case since transient retinal folding has been rarely documented, and as far as we are aware, has not been previously investigated by ultrasonography.

Adrenal Cortex Hormones↗
PubMed1984

Nearpoint visual stress: a physiological model.

The nearpoint visual stress theory holds that a tendency for convergence to localize closer than accommodation is intrinsic to the nearpoint visual demands imposed by our culture. A physiological model is presented, suggesting that this effector system mismatch arises from the activation of autonomic reflexes related to stress, vigilant attention and information-processing. Autonomic arousal exerts a cycloplegic-like effect. Excess accommodative effort, which must be exerted to achieve required accommodation, produces a tendency towards overconvergence. The demand for integration of accommodation and convergence, essential for efficient nearpoint function, is thus incompatible with our own physiology, since autonomic arousal is inherent in task demands for attention and mental effort associated with reading. Additionally, autonomic arousal is generated by the high levels of stress pervasive in our society. Various refractive, binocular and accommodative deviations may arise adaptively in order to resolve this mismatch and facilitate efficient nearpoint visual function. These nearpoint stress-induced visual disorders parallel stress-induced systemic illness in that both result from the activation of physiological processes which are inappropriate for the demands and stresses of our society.

Accommodation, Ocular↗
PubMed1983

A clinical comparison of mydriatics.

Clinicians use various topical agents for mydriasis in evaluation of the retina and its periphery. This paper shows the use of two mydriatic methods for this procedure--a combination of one drop 1% tropicamide (Mydriacyl) and the drop 1% hydroxyamphetamine hydrobromide (Paredrine) in comparison with the regimen of two drops 1% tropicamide (Mydriacyl) separated by five minutes. The degree of dilation, the resistance to intense comparable binocular indirect ophthalmoscope (BIO) illumination and the time recovery from these agents were evaluated in an optometric clinical setting. The same degree of mydriasis was demonstrated at the p greater than 0.01 level with these two regimens. The two regimens appear to be clinically similar for cycloplegic and mydriatic recovery time.

Adult↗
PubMed1984

Malignant glaucoma occurring 16 years after successful filtering surgery.

Malignant (ciliary block) glaucoma occurred in a patient 16 years after successful filtering surgery for glaucoma. Initially a moderate rise in intraocular pressure (IOP) occurred despite a functional filtering bleb. Pilocarpine treatment was started and exaggerated the attack of malignant glaucoma. The possibility that malignant glaucoma had occurred 16 years after successful filtering surgery was not appreciated until the anterior chamber deepened and a fall in IOP occurred with instillation of cycloplegic drops into the eye.

Female↗
PubMed1982

Anisometropic amblyopia in Macaca nemestrina monkeys produced by atropinization of one eye during development.

Two macaque monkeys were reared with daily administration of the cycloplegic drug, atropine, to one eye until 8 months after birth. Behavioral testing of contrast sensitivity functions in the atropinized eyes during the rearing period demonstrated that this rearing procedure caused the treated eyes to be chronically defocused. Measurement at the age of 6 or 8 months of contrast sensitivity while optically correcting the defocus demonstrated that an amblyopia had developed in the treated eyes. Furthermore, the relative magnitude of the amblyopia across spatial frequencies was similar to the relative magnitude of the defocus. Subsequently testing at 1 year of age demonstrated that the deficits persisted for several months after termination of the defocus rearing. This rearing procedure appears to provide a reasonable primate model with which to study anisometropic amblyopia in monkeys.

Age Factors↗
PubMed1978

[Malignant glaucoma (author's transl)].

A 35-year-old male, one of three siblings with spherophakia and glaucoma, was treated surgically by aspiration of vitreous through a posterior sclerotomy wound, and air insufflation of the anterior chamber in each eye. Previous peripheral or sector iridectomies were not helpful in contolling the condition. Some improvement was noted with intensive cycloplegic therapy in each eye. In the right eye, one surgical procedure was sufficient to arrest the condition. In the left eye, a sector iridectomy, and three posterior sclerotomies combined with air insufflations of the anterior chamber have been unsuccessful in controlling the pressure. A further sclerotomy with a vitrectomy instrument to remove most of the formed vitreous followed by air insufflation of the anterior chamber is proposed for the uncontrolled eye and if this is not successful in controlling the condition, lens extraction will be carried out.

Adult↗
PubMed1978

Automatic refraction and the private ophthalmologist: Dioptron II compared with subjective examination.

The author carried out manifest followed by cycloplegic retinoscopy and subjective refraction in 84 office patients. An ophthalmic assistant examined them on the Dioptron II refractor. The results were compared. There was 46% agreement to the nearest +/- .025D for spheres, 51% for cylinders and 44% for spherical equivalents. After cycloplegia, agreement was 47%, 51% and 51% respectively. Axis agreement to the nearest 5 degrees was 46% without and 29% with cycloplegia. Statistical correlation showed this optometer to be most accurate for spheres, less for axes and least for cylindrical powers. In most patients it was more accurate without cycloplegia than with and provided a useful starting point for refraction. It was less useful for children under 8, in elderly, psychiatric and some non-English-speaking patients.

Aged↗
PubMed1995

Refractive error and axial length in a primate model of strabismus and congenital nystagmus.

PURPOSE: To evaluate the development of refractive error and axial length in a primate model of sensory strabismus and nystagmus. METHODS: Four macaque monkeys had alternating tarsorraphy beginning within 24 hours of birth. One eye was closed for 25 days, and when it opened, the second eye immediately was closed for the next 25 days. Cycloplegic refractions and axial lengths were determined prospectively for three animals for 1 year or more. These data were compared to those of three unsutured control macaques raised under otherwise similar conditions. RESULTS: Each experimental animal developed exotropia and nystagmus. The first occluded eyes were significantly more hypermetropic than the control eyes at 1 month of age (+7.25 D +/- 1.95 D versus +1.92 D +/- 1.27 D; P < 0.02) and remained significantly more hypermetropic throughout the study. The second occluded eyes were more hypermetropic than the control eyes at 1 month (+2.42 D +/- 2.13 D versus +1.92 D +/- 1.27 D; P = 0.20), but less hypermetropic than the first occluded eyes. The rate of emmetropization was slightly faster for the first occluded eyes than for the control eyes (-0.12 D/month compared to -0.03 D/month). The mean axial length measurements of the experimental and control eyes were the same at 1 month, and their rates of change over time were identical. CONCLUSIONS: Persistent hypermetropia was produced by a brief period of reverse neonatal eyelid closure in a model of congenital-like nystagmus. It is suggested that infantile lid closure, nystagmus, or amblyopia after neonatal visual disruption may be associated with a failure of normal emmetropization.

Animals↗
PubMed1994

Lessons on dilation.

Mydriatics cause pupil dilation by blocking the responses to the sphincter muscle of the iris from cholinergic stimulation. Cycloplegics paralyze the action of the ciliary muscles thereby prohibiting accommodation of the lens.

Humans↗