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At least 1,009 records · Page 56Linked to original sources
PubMed2000

Multiple sclerosis with normal neuro-ophthalmological work-up: results of focal stimulations induced by a scanning laser ophthalmoscope.

OBJECTIVE: Visual evoked potentials (VEPs) are a very useful tool in diagnosis of multiple sclerosis (MS). Nevertheless, in some cases of the disease, VEPs are normal. The aim of this study was to evaluate the diagnostic value of focal checkerboard reversal stimulation based on opto-acoustic modulation generated by a scanning laser ophthalmoscope (SLO) in patients whose standard neuro-ophthalmological work-up was normal. METHODS: We prospectively studied 185 MS patients. In this cohort we found 30 patients with definite MS and normal neuroophthalmological work-up and we studied the diagnostic yield of focal visual stimulation in these patients. We performed focal SLO-elicited VEPs with two different spatial distributions: a central 8 x 8 degrees square field and a central 8 x 8 degrees exclusion square. The results were analysed in terms of age of the patient, course of the disease, and disability evaluated on the Expanded Disability Status Scale (EDSS). RESULTS: Mean latencies of focal VEPs were increased in MS patients compared to controls. In MS, focal stimulation allowed dysfunction of the visual system to be detected in 50% of patients who have been classified as normal according to conventional VEPs. VEP abnormalities were found to be correlated with the EDSS score (P<0.001) and the course of the disease (P<0.05). CONCLUSION: We have demonstrated the value of focal VEPs in MS diagnosis using SLO-based techniques. Further prospective work in patients with possible and probable MS should enable an evaluation of the sensitivity and specificity of this method in the early diagnosis of MS.

Adult↗
PubMed2001

A child with muscle-eye-brain disease. Ophthalmological and neurological characteristics.

PURPOSE: To describe a child with Muscle-Eye-Brain disease (MEB), one of three types of congenital muscular dystrophy associated with ocular abnormalities. METHODS: Case report. RESULTS: The child showed severe visual impairment due to progressive myopia and retinal degeneration, a pachygyria-type of migration disorder of the brain with a nodular cortical surface, i.e. cobblestone cortex, as well as muscular weakness and severe mental retardation. CONCLUSION: Ophthalmological assessments are important to help to diagnose and follow children with congenital muscular dystrophy.

Abnormalities, Multiple↗
PubMed2001

Visual screening of Swedish children: an ophthalmological evaluation.

PURPOSE: This study describes the various ophthalmological conditions detected in the Swedish visual screening program for children. METHODS: The study was longitudinal and retrospective. All children (3126) born in 1982 in three Swedish municipalities have been followed from birth to ten years of age. Visual acuity was examined at the ages of 4, 5.5, 7 and 10 years. Before the age of 4, a gross examination of the eyes was performed. RESULTS: The prevalence of ametropia in the population was 7.7%, the prevalence of strabismus 3.1%, and the prevalence of organic lesions 0.6%. Seven children (0.2%) were visually handicapped (visual acuity </=0.3 in the better eye). Refractive errors and microtropias were mainly detected at the age of 4, when the first visual acuity test was performed, while manifest strabismus was in many cases detected before this age. With this screening and subsequent diagnosis and treatment, the prevalence of deep amblyopia (visual acuity </=0.3) has been reduced from 2% to 0.2%. With treatment, 47% of the amblyopic children achieved a visual acuity better than 0.7. CONCLUSION: Visual screening is effective in detecting visual and ocular disorders. Most conditions are discovered before the age of 6. Compared to an unscreened population, the prevalence of amblyopia is greatly reduced.

Age Distribution↗
PubMed1990

Screening for glaucoma in the community by non-ophthalmologically trained staff using semi automated equipment.

Eighty-nine and a half per cent of the population of a general practice over the age of 49 years were screened for glaucoma and high risk ocular hypertension requiring treatment. Screening took place using semi-automated intraocular pressure and visual field equipment operated by non-ophthalmologically trained staff. An experienced ophthalmologist examined all patients in a single blind manner to reduce false negatives to a minimum. Patients suspected of requiring treatment on the grounds of raised intraocular pressure, abnormal visual fields or suspicious optic discs were subsequently examined in a hospital clinic. Treatment criteria, as commonly practiced, were carefully defined and the sensitivities and specificities of the methods of screening used were calculated. One and three tenths per cent of the practice population were known to be receiving treatment prior to the study and a further 1.4% were found to require treatment after screening. The sensitivity and specificity of the non-contact tonometer were 91.7% and 95.6% respectively with a predictive power of 22.5% for a positive result. The mean time taken to perform the test in both eyes was two minutes. Seventy per cent of the patients with pressures over 22 mmHg in both eyes on screening were found to require treatment. The routine use of the field screener did not increase either the sensitivity or specificity of the screening process but its use in cases with raised intraocular pressure is advised to indicate the degree of urgency of the referral. An algorithm based on the results of the study is suggested when planning the use of semi-automated equipment to screen for ocular disease related to raised intraocular pressure.

Aged↗
PubMed1991

Ophthalmologic manifestations of carotid occlusive disease.

Amaurosis fugax is perhaps the best known ocular symptom of carotid vascular disease. An understanding of the symptoms and an ability to recognise the characteristic changes of hypotensive retinopathy and the ocular ischaemic syndrome should be familiar to ophthalmologists. In patients with known cerebrovascular disease a careful ophthalmologic examination should be performed to evaluate for the presence of ocular involvement related to emboli and hypoperfusion. Once identified a variety of non-invasive and invasive techniques may be employed to determine the degree of stenosis and an individual treatment plan initiated. Early recognition and treatment of patients with carotid occlusive disease may prevent more serious complications.

Aged↗
PubMed1995

Biofilm-related infections in ophthalmology.

A biofilm is a functional consortium of microorganisms organised within an extensive exopolymer matrix. Organisms within a biofilm are difficult to eradicate by conventional antimicrobial therapy and can cause indolent infections. This paper reviews the pathophysiology of biofilms and their application of ophthalmology. Under certain environmental conditions such as nutrient limitation, some bacteria may secrete and reside in an exopolysaccharide glycocalyx polymer. This confers relative protection from humoral and cellular immunity, antibiotics and surfactants. Biofilms occur in natural aquatic ecosystems, on ship hulls, in pipelines and on the surface of biomaterials. They cause clinical infections of prosthetic hip joints, heart valves and catheters. Biofilm formation may occur rapidly on contact lenses and their cases and hence contribute to the pathogenesis of keratitis. Formation of biofilms is also implicated in delayed post-operative endophthalmitis and crystalline keratopathy. Bacteria within biofilms are 20-1000 times less sensitive to antibiotic than free-living planktonic organisms. Existing experimental methods for modifying biofilm include the use of macrolide antibiotics that specifically impair biofilm production, and the use of enzymes to digest it. These may have clinical applications, as potential adjunctive therapies to antibiotic treatment, for these resistant infections. In conclusion, biofilm is an important cause of infections associated with biomaterials. Novel strategies are needed to deal with these.

Biofilms↗
PubMed2000

Ophthalmological and intracranial anomalies in patients with clinical anophthalmos.

PURPOSE: To better describe the clinical and neuroimaging spectrum of abnormalities in clinical anophthalmos. METHODS: We performed a retrospective review of all 17 patients admitted to the King Khaled Eye Specialist Hospital with clinical anophthalmos over a 15 year period who had a complete ophthalmological examination documented and received computed tomographic (CT) imaging of the orbits and brain. RESULTS: Patients with clinical anophthalmos had a high incidence of developmental abnormalities involving both eyes (15/17 patients, 88%), the brain (12/17 patients, 71%) and the body (7/12, 58%). The incidence of central nervous system anomalies reached 100% in patients with bilateral small optic nerves on CT scan. CONCLUSIONS: Patients with clinical anophthalmos share a similar constellation of neurological, somatic and neuroradiological abnormalities as patients with microphthalmos, septo-optic dysplasia and clinical optic nerve hypoplasia. This fact may provide insight into developmental abnormalities of the afferent visual system and brain.

Abnormalities, Multiple↗
PubMed2001

Ophthalmologic manifestations of rheumatic diseases.

OBJECTIVES: Detailed review of the manifestations of eye involvement in the context of rheumatic diseases. METHODS: An OVID Medline search of the rheumatology and ophthalmology English literature related to the eye manifestations of human rheumatic diseases from 1966 to the present was conducted by the authors. RESULTS: Analysis of 300 recent and consecutive rheumatology consultations from a large Veterans Administration Healthcare System shows that 4% are referred for eye manifestations of suspected rheumatic diseases, most commonly, anterior uveitis and keratoconjunctivitis sicca (KCS). Ocular involvement is common in the rheumatic diseases but varies among the different disorders. A literature review indicated that the most common ocular manifestations of rheumatic diseases include keratoconjunctivitis sicca, anterior uveitis, and scleritis. The most serious eye complications of the inherited connective tissue disorders are lens involvement with cataract formation or subluxation. The most significant side effects of the drugs used to treat rheumatic diseases are the maculopathy associated with anti-malarial agents and cataracts and glaucoma associated with corticosteroid use. Although many of the eye manifestations are easily recognizable, consultation with an ophthalmologist is usually necessary for optimal treatment and prevention of complications. CONCLUSIONS: The rheumatologist, in coordination with the ophthalmologist, can play a major role in detecting and managing the eye involvement in his patients to save this important sense. Understanding the varied manifestations of eye disease will permit the rheumatologist to better evaluate the activity of the rheumatic disease.

Eye Diseases↗
PubMed2000

[Retinopathia centralis serosa--stomach ulcer of ophthalmology?].

Centralis serosa retinopathy is regarded in ophthalmology as a psychosomatic disease, although this assumption has not been satisfactorily proven so far. With the use of the Freiburg Personality Inventory (FIP, [4]), the questionnaire for the evaluation of psychosomatic pathological processes [10], and by recording the affliction undergone by stressful events in the patients' lives, the question as to whether a psychogenic contributory cause existed was examined with a control group study (n = 11), parallelised according to age and sex. The results proved significantly that there was a psychosomatic connection, specifically a tendency to somatisation in patients with centralis serosa retinopathy. However, it was not possible to compile a typical personality profile, although it was possible to describe some conspicuous personality features. As a conclusion, the consequences for a subsequent study are being discussed.

Adult↗
PubMed2002

[Standard designs of epidemiological studies and their characteristics in ophthalmology].

This text gives an overview on standard epidemiological study designs and their main advantages and limitations concerning clinical and economical aspects, of performance. Ophthalmological examples are used to illustrate the design characteristics of cross-sectional, cohort and case control studies. These designs are compared by the fictitious planning of an epidemiological study to assess the prophylactical relevance of intraocular antibiotics against post-cataract endophthalmitis; general practical hints for the designing of epidemiological studies are given.

Antibiotic Prophylaxis↗
PubMed2002

[The St. Gallen digital ophthalmological imaging system].

BACKGROUND: Digital photography has many advantages over the conventional method. At present commercially available digital ophthalmological imaging systems utilise only a fraction of the advantages of this technique and some of them have fundamental conceptional problems. METHODS: Images of a fundus camera, a slit lamp and a scanning laser ophthalmoscope were digitised using digital and video cameras and/or frame grabber cards. Digital images and movies were recorded via a personal computer. The image recording software was developed using an imaging library and open source software. The recorded images and video sequences were processed with three different commercially available programme packages. The images were archived in a around-the-clock accessible database. RESULT: Our digital imaging system is capable to record normal and high resolution slit lamp images, colour fundus images in normal resolution, Fluorescein angiography images in normal and high resolution, digital simultaneous ICG and Fluorescein videoangiograms (without compression) and high resolution macro images. Different functions, e.g., contrast enhancement are integrated in the image capture software. Most of the parameters of the image acquisition are individually adaptable. The digital image archive supports multiple image and video formats. CONCLUSIONS: Using standard software and hardware components an imaging system can be constructed featuring functions usually not available in commercial ones. Since the system is adaptable, recording of images with a wide variety of parameters, e.g., for measurements for scientific experiments, is possible.

Computer Systems↗
PubMed2002

[In paediatric ophthalmology there is no preferred timing for retinoscopy].

BACKGROUND: In paediatric ophthalmology retinoscopy may be performed immediately after an orthoptic examination or during an additional ambulatory visit. So far, no studies have been performed to investigate which of both procedures is preferred by the persons accompanying or examining the children. PATIENTS AND METHODS: 32 consecutive children under the age of 16 were randomly assigned to have retinoscopy immediately after the orthoptic examination or during an additional visit. Children coming from far away or needing a cycloplegia with atropine were excluded from this study. The accompanying persons and the examiners (orthopedist/physician) were interviewed using a validated, written questionnaire. Associations between answers were determined via a cluster analysis. RESULTS: 84 % (28/32) of all accompanying persons returned the questionnaire. The timing of retinoscopy was not associated with other variables. The question "Would you recommend our Department?" was strongly associated with how the accompanying persons judged the medical and orthoptic examination and also with the waiting times. CONCLUSIONS: There is no difference for the accompanying persons and the examiners if retinoscopy is performed immediately after an orthoptic examination or during an additional visit. As reported in the literature about patient satisfaction in an ambulatory setting, we found that the satisfaction of the accompanying persons correlated with the interaction between health professionals and the persons accompanying the children, as well as with the waiting times.

Adolescent↗
PubMed2005

[Substances for staining biological tissues: use of dyes in ophthalmology].

The azo dye trypan blue and the cyanine dye indocyanine green have been used in ophthalmology since the 1980 s to dye the anterior capsule in cataract operations and to stain epiretinal membranes in order to remove the membrana limitans interna (ILM). By means of a standardized in vitro test in accordance with DIN EN ISO 10993, it has now been shown that both dyes and the theoretically possible alternatives - the anthrachinone alizarincyanine green and the trityl dyes fast green and lissamine green - are cytotoxic in the normal concentrations of maximum 1.5 g/l. On the other hand, the new product Blueron(R) with the trityl dye patent blue, which has been developed to dye the anterior capsule, is completely biocompatible, even at a high dosage of up to 2.8 g/l.

Anthraquinones↗
PubMed2006

Neuro-ophthalmologic manifestations of psychogenic disease.

From a neuro-ophthalmologic standpoint, five areas may be affected by psychogenic disease: (1) vision, including visual acuity and visual field; (2) ocular motility and alignment; (3) pupillary size and reactivity; (4) eyelid position and function; and (5) corneal and facial sensation. The physician faced with a patient complaining of decreased vision or some other disturbance related to the afferent or efferent visual systems for which there is no apparent biologic explanation has three responsibilities. First, the physician must ascertain that an organic disorder is not present. Second, the physician should induce the patient to see or do something that would not be possible if the condition were organic in nature. Finally, the physician should attempt to determine whether the patient has an underlying psychiatric disease or is experiencing psychosocial stress. In this article, manifestations of psychogenic disease as they pertain to vision are considered, and, where appropriate, the various methods used to diagnose and treat these phenomena are discussed.

Accommodation, Ocular↗
PubMed1982

[Use of ultrasound in ophthalmology].

In ophthalmology, ultrasound is applied in diagnostics as well as in surgery and therapy. This paper gives a short survey on both applications. Ultrasonic phacoemulsification is of considerable practical importance for modern cataract micro-surgery with intraocular lens implantation. Applications of that kind require consideration of ultrasonic bioeffects and equipment safety. Diagnostic use of ultrasound includes biometry (echometry), tissue examination and characterization, and vascular investigations in eye and orbit. The application of diagnostic ultrasound on in-patients, its individual indications, and the appropriate methods (A, B, automatic biometric devices for axial length measuring, M, Doppler) are described. Examples of commercially available instruments for the different applications are given. In comparison with other disciplines ophthalmic A-mode and B-mode echography is characterized by: refined depth resolution and lateral resolution; the important part of quantitative methods for clinical evaluation of echograms; and the advanced level of quality assurance for equipment performance. Refined tissue evaluation requires optimized and reproducible equipment parameters. To ensure these conditions the clinical echographer must be educated and willing to test performance and quality of his equipment. Finally, a perspective of actual research in diagnostic ultrasound of the eye is given.

Equipment Design↗
PubMed1999

[No contamination of medical personnel by desflurane and nitrous oxide inhalation anesthetics during surgical interventions in ophthalmology].

BACKGROUND: Possible health hazards from chronical exposure to inhalational anesthetics cannot definitively be excluded. PATIENTS AND METHODS: Trace concentrations of nitrous oxide and desflurane were continuously every 90 seconds determined in the breathing zone of both ophthalmologist and anesthesiologist during strabism surgery in 20 children by a infrared spectrometer. RESULTS: During anesthesia, the surgeon was exposed to the inhalational agents used, but concentrations were well within the legal limits. CONCLUSIONS: Despite minor occupational exposure of the operating room staff during the operative procedures, inhalational anesthesia in ophthalmologic operative procedures can be considered safe from the standpoint of modern work place laws and health care regulations.

Air Pollutants, Occupational↗
PubMed1999

[Ophthalmologic examination of the infant].

BACKGROUND: The examination of the infant needs patience, special knowledge and skills to get to a reliable judgment of the visual functions of the child. For the practitioner it is important to rely on clinical methods without the apparatus reserved to ophthalmologic institutions. METHODS: Based on the literature and personal experience the clinical examination techniques for infants are presented and the results are discussed with respect to the possible diagnosis. CONCLUSION: Simple clinical tests reveal most symptoms in the infant. Electrophysiological tests and imaging procedures are sometimes necessary.

Child, Preschool↗
PubMed1998

[Digital internet-based ophthalmologic image databank].

OBJECTIVE: To manage an ophthalmological image database easily and rationally. MATERIALS AND METHODS: Fundus, macro and simultaneously recorded Fluorescein and ICG angiography images were digitized and archived using personal computers and UNIX workstations. Image data were written to CD-recordables. The CD-s with image information were stored in a jukebox-server. On demand image information was converted to dynamic hypertext markup language (html) with a WWW-server. Information stored on the servers could be observed with browser programs running on client computers connected to local area network. The communication with ophthalmologist working outside our hospital was realized by electronic mail. RESULTS: Different platforms (PC, Mac, workstations, etc.) and operating systems (Windows 3.x, 95, NT, MacOS, UNIX, etc.) can be used as clients. The communication with the system is accomplished by standard internet programs (Internet Explorer, Netscape Navigator, etc.). Thanks to the intuitive graphical user interface, no special computer knowledge is required to retrieve the stored data. CONCLUSION: Our digital image database has many advantages over a conventional image archive: it is round the clock available, images can be stored and copied without loss of quality, digital images can be easily integrated in other applications, it can be used without special computer knowledge, it is expandable and compatible with all contemporary computer platforms.

Computer Communication Networks↗