SEARCH · Search PubMed

Results for “DIPLOPIA”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,441 records · Page 80Linked to original sources

PubMed1994

Fixation duress in the pathogenesis of upper eyelid retraction in thyroid orbitopathy. A prospective study.

BACKGROUND: Upper eyelid retraction in thyroid eye disease may be caused by proptosis, levator and Müller's muscle infiltration with fibrosis or individual fiber enlargement, excessive sympathetic innervation, abnormal adhesions between levator palpebrae muscle and surrounding tissues, or fixation duress. Fixation duress refers to upper eyelid retraction while fixating with an eye with inferior rectus muscle restriction due to excessive simultaneous firing of the ipsilateral superior rectus and levator palpebrae muscles. METHODS: The authors prospectively examined six patients with strabismus and thyroid eye disease associated with inferior rectus restriction and upper eyelid retraction in whom the eyelid retraction was suspected clinically to be a result of fixation duress. All six patients underwent recession of both inferior recti ranging from 3 to 6.5 mm (mean, 4.5 mm) to improve the ocular motility and alignment, reduce the diplopia, and mitigate the upper eyelid retraction. RESULTS: Reduction of upper eyelid retraction measured as the preoperative versus postoperative difference in corneal light reflex-upper eyelid margin measurements was achieved in all patients postoperatively, ranging from 1.5 to 5.5 mm (mean, 3.2 mm). Only one patient showed significant residual retraction to warrant consideration of upper eyelid surgery. CONCLUSION: Fixation duress plays a significant role in upper eyelid retraction of thyroid eye disease in a subset of patients with restriction of the inferior rectus muscle. In this selected group of patients, the upper eyelid retraction may be reduced or eliminated upon proper recession of the tight inferior rectus muscle(s).

Diplopia↗

PubMed1995

Inferior oblique muscle injury from local anesthesia for cataract surgery.

BACKGROUND: Vertical rectus muscle injury is commonly cited as a cause of strabismus after cataract surgery. Injury to the inferior oblique muscle or nerve as a complication of cataract surgery has not been described previously. METHODS: Four patients without pre-existing strabismus who had diplopia after cataract surgery were studied. Analysis included prism and cover testing, Lancaster red-green testing, and fundus torsion assessment. RESULTS: Three patients had a delayed-onset hypertropia with fundus extorsion in the eye that underwent surgery, which is consistent with inferior oblique muscle overaction secondary to presumed contracture. The fourth patient had an immediate-onset hypotropia with fundus intorsion in the eye that underwent surgery, which is consistent with inferior oblique muscle paresis. Damage to a vertical rectus muscle or "unmasking" of a pre-existing superior oblique muscle paresis could not explain the history and findings in this group of four patients. CONCLUSION: The inferior oblique muscle contracture observed in three patients may have been caused by local anesthetic myotoxicity, whereas the paresis observed in one patient may have been due to mechanical trauma or anesthetic toxicity directly to the nerve innervating the muscle. Inferior oblique muscle or nerve injury should be considered as another possible cause of postoperative strabismus, especially when significant fundus torsion accompanies a vertical deviation.

Aged↗

PubMed1998

Fisher syndrome associated with IgG anti-GQ1b antibody following infection by a specific serotype of Campylobacter jejuni.

OBJECTIVE: The purpose of the study was to describe clinical and serologic features of Fisher syndrome associated with IgG anti-GQ1b ganglioside antibody following Campylobacter jejuni enteritis. DESIGN: A clinical trial. PARTICIPANTS: Four consecutive patients with Fisher syndrome were studied. INTERVENTION: Samples of sera from four patients were tested for reactivity to GQ1b ganglioside by enzyme-linked immunosorbent assay (ELISA). Campylobacter jejuni strains isolated from samples of stool from three patients were serotyped by the method of Penner and Hennessy and that of Lior. MAIN OUTCOME MEASURES: Serum IgG anti-GQ1b antibody titer and serotypes of C. jejuni. RESULTS: Diplopia occurred 8 to 14 days after the onset of diarrhea. Campylobacter jejuni was isolated from samples of stool from all of the patients. ELISA revealed a high serum IgG anti-GQ1b antibody titer for all four patients. Two patients had high serum titers of other antiganglioside antibodies frequently related to Guillain-Barré syndrome. These two patients developed limb weakness following the onset of ophthalmoplegia. The C. jejuni serotype was Penner's serotype 2 for all three of the patients tested. CONCLUSIONS: These findings suggest that C. jejuni, especially Penner's serotype 2, enteritis could trigger development of Fisher syndrome associated with IgG anti-GQ1b antibody.

Adolescent↗

PubMed2004

[Orbital extension of sinus plasmacytoma secondarily transforming into multiple myeloma: a case study].

We report the case of a 39-year-old man who consulted for severe exophthalmia with diplopia associated with chronic sinusitis evolving over 6 months. A cervicofacial CT scan showed a tumoral mass invading the maxillary and ethmoidal left sinus and orbital cavity. A biopsy of the mass and general evaluation confirmed the diagnosis of extramedullary plasmocytoma. Secondarily it transformed into multiple myeloma. In light of this case of extramedullary plasmocytoma in a young subject, we discuss the clinical characteristics, ophthalmologic manifestations, and the various therapeutic modalities according to the stage of the disease and the ocular repercussions.

Adult↗

PubMed2004

[Abducens nerve palsy in spontaneous intracranial hypotension].

Described by Schaltenbrand (1940), spontaneous intracranial hypotension is an unusual syndrome, sometimes revealed by an abducens nerve palsy motivating the patient to consult emergency ophthalmology services. The Authors report the case of a 50-Year-old Turkish woman who presented with diplopia due to a left abducens nerve palsy. These symptoms were associated with headache and nausea. Brain magnetic resonance imaging demonstrated diffuse pachymeningeal enhancement with gadolinium. A lumbar puncture showed low spinal fluid pressure (6 cm H2O), leading to the diagnosis of palsy by spontaneous intracranial hypotension. First, a classic treatment was prescribed with no result: increased water intake, corticoid therapy, and rest. Then a blood patch consisting of an injection of autologous blood by lumbar puncture between the third and fourth lumbar vertebrae to plug the spontaneous leak of spinal fluid, with success. A review of the literature provides information on the physiopathological mechanism, the clinical and imaging symptoms, and the treatment.

Abducens Nerve Diseases↗

PubMed2004

[Orbital fat decompression techniques].

Fat removal orbital decompression (FROD) was first described by Olivari in 1988. Through a blepharoplasty approach, fat pads from the five palpebral pockets, as well as intraconal fat, are carefully removed. The main complications are retrobulbar hemorrhage and postoperative diplopia. The best indications are patients with wide orbits without compressive optic neuropathy. FROD is an inescapable procedure in a balanced approach to surgical orbital decompression.

Blepharoplasty↗

PubMed1999

Long-term sequelae after surgery for orbital floor fractures.

A surgical technique involving exact repositioning and rigid fixation is required for the reduction of fractures of the orbital floor. Even then, sequelae may be present long after the trauma. The aim of this study was to establish the frequency and type of sequelae after surgery for orbital floor fractures and to investigate the extent to which the method of surgery had any impact on the severity of the sequelae. A questionnaire was sent to all 107 patients (response rate 77%) 1 to 5 years after the injury. Further clinical data were obtained from the patients' charts. Eighty-three percent of the patients were affected by some kind of permanent sequelae in terms of sensibility, vision, and/or physical appearance. A high frequency of diplopia (36%) was related to the reconstruction of the orbital floor with a temporary "supporting" antral packing in the maxillary sinus, a technique which has now been abandoned at our department in favor of orbital restoration with sheets of porous polyethylene. Our conclusion is that, because long-term sequelae are common, the surgical technique must be subjected to continuous quality control to minimize future problems for this group of patients.

Adolescent↗

PubMed1990

Intracavernous carotid aneurysm--an unusual cause of isolated abducens nerve palsy.

We discuss the case of a 59-year-old woman who presented to the emergency department with complaints of diplopia for five days. Physical examination disclosed an isolated complete right abducens nerve palsy. Angiography revealed a giant aneurysm from the postcavernous portion of the right internal carotid artery. This case illustrates an unusual etiology of a unilateral abducens nerve palsy.

Abducens Nerve↗

PubMedDate not supplied

Endonasal endoscopic resection of ethmoido-orbital osteoma compressing the optic nerve.

Osteomas are the most common benign tumors of the paranasal sinuses. Open procedures for removal of ethmoid osteomas have been the method of choice, but debate over optimal treatment continues. We report resection of a large ethmoido-orbital osteoma via endonasal endoscopic approach with minimal morbidity. A 42-year-old man presented with a 1-year history of slowly progressive proptosis and lateral gaze diplopia. Imaging studies of orbits and sinuses revealed a large bony mass in left ethmoid sinus extending into the left orbit. The mass had compressed and slightly diverted the optic nerve. The patient had also bilateral extensive polyposis for which bilateral ethmoidectomy and sphenoidotomy were performed. Using a curved blunt elevator, the osteoma was gently and meticulously detached from adjacent structures. Finally, frontal recesses were cleaned form the polyps. The postoperative period was uneventful. After 18 months, he is still free of symptoms. The previously used management modality of symptomatic osteomas has mostly consisted of open approaches. Endonasal endoscopic approach provides a safe and effective alternative to open approaches, offering cosmetic advantages and lowering the morbidity. This approach could be judiciously used in large ethmoido-orbital osteomas in selected cases.

Adult↗

PubMed2001

[Idiopathic orbital myositis].

INTRODUCTION: Orbital myositis is a subtype of nonspecific orbital inflammation confined to one or more of the extraocular muscles. EXEGESIS: Three female patients presented presumed orbital myositis, in each of whom the diagnosis was suspected clinically and confirmed by the computed tomography (CT) scan appearances. All presented with orbital pain, diplopia and periorbital edema. All patients responded to systemic corticosteroid with prompt resolution of symptoms and signs, but one patient had recurrent episodes of myositis, leading to the prescription of azathioprine. The clinical and radiological constellation of findings allowing a definitive diagnosis of the nonspecific orbital inflammatory syndrome in most cases is discussed. CONCLUSION: The nonspecific orbital inflammatory syndromes are a heterogenous group of conditions and the CT scan is a valuable tool in differentiating these conditions. Most cases of idiopathic orbital myositis require corticosteroids, but therapeutic alternatives to corticosteroids in refractory diseases are warranted.

Adult↗

PubMed2001

[Myasthenia gravis and elderly persons. A case study].

INTRODUCTION: Myasthenia gravis is an uncommon autoimmune disease which affects all ages. There are late-onset occurrences whose diagnosis is not considered often enough in geriatrics. EXEGESIS: We report a case of late-onset myasthenia gravis with a 78-year-old woman who was multi-pathologic and hospitalized for a diplopia check-up and recurrent falls. These stress the difficulty of suggesting myasthenia gravis in geriatrics due to the number of differential diagnoses that can mislead the physician. For the elderly subject, the diagnostic methodology is close to that of the younger subject. The search for related diseases must be systematic. CONCLUSION: Late-onset myasthenia gravis must remain a diagnosis present in the mind of the physician because of the significant improvement of the functional prognosis after the start of the treatment. The majority of subjects will recover a normal life.

Accidental Falls↗

PubMed1998

[Diabetes insipidus revealing primary malignant non-Hodgkin's lymphoma of bone].

INTRODUCTION: Diabetes insipidus is a very rare, occasionally misleading, revealing symptom of non Hodgkin's malignant lymphoma. We report a case of this uncommon association and a review of the literature is done. EXEGESIS: Soon after a transient attack of diplopia due to a 6th cranial nerve palsy, idiopathic cerebral diabetes insipidus was diagnosed in a 32-year-old immunocompetent man. As anterior hypopituitarism was absent, the patient was discharged and treated with desmopressin acetate. Six months later, recurrence of diploplia together with raised erythrocyte sedimentation rate was observed and B cell lymphoma was observed in the iliac bone and skull, with extension into the right cavernous sinus. Both tumoral lesions led to important uptake of gallium-67. After a 26-month follow-up following intensive chemotherapy including autologous peripheral stem cell transplantation and local radiotherapy, lymphoma symptoms had disappeared, but the patient's condition had only partially improved with regard to diabetes insipidus. The association of lymphoma and diabetes insipidus which has only been reported in 14 cases is discussed. CONCLUSION: Since endocrine symptoms are often preceding hematological diagnosis, malignant lymphomas should systematically be viewed as potential etiology of diabetes insipidus. Magnetic resonance imaging which is more sensitive than computerized tomography in revealing brain lymphomas is mandatory. Gallium scan imaging might help guide the diagnosis in some instances.

Abducens Nerve↗

PubMed1998

Contralateral coronoid process bone grafts for orbital floor reconstruction: an anatomic and clinical study.

PURPOSE: This study compares the contour of the coronoid process with the orbital floor using skulls and shows the use of this bone as a graft for orbital floor reconstruction. METHODS: Measurements and contour evaluations of the orbital floor and the contralateral mandibular coronoid process (12 right orbital floors with the lateral surface of the left coronoid process and 12 left orbital floors with the lateral surface of the right coronoid processes) were made in 24 dried adult human skulls (age, race, gender unknown) to assess the feasibility of using the mandibular coronoid process for orbital floor reconstruction. Applying the findings of this study, eight patients who had sustained either an isolated orbital floor blowout fracture (n = 2) or orbital floor compromise with an associated zygomatic bone fracture (n = 6) were treated by using their contralateral coronoid process for repair of the orbital floor. RESULTS: Anatomic Study: Measurements and contour comparisons of the right orbital floor with the left lateral cortex of the coronoid process in 12 skulls and the left orbital floor with the right lateral cortex of the coronoid process in the another 12 skulls showed a close match in contour and demension. CLINICAL STUDY: Although minimal trimming of the peripheral bony margins and medial coronoid cortical plate was needed, none of the grafts required recontouring of their lateral cortical surface in the eight patients. Postoperative radiographic studies showed a correct anatomic contour of the orbital floor. A 1-year follow-up of each patient showed no occurrence of diplopia, enophthalmia, muscle entrapment, or infection. All eight patients had transient (1 to 2 weeks) trismus. CONCLUSION: Based on the anatomic studies and clinical results, the coronoid process makes an excellent donor graft site for reconstruction of orbital floor deformities.

Adult↗

PubMed1976

Treatment of zygomatic fractures: internal wiring-antral-packing-reposition without fixation.

Fifty-two patients with zygomatic fractures were examined clinically and roentgenologically 1 to 4 years after treatment. Of these patients, 15 were treated with wiring fixation, 26 with antral packing using plastic tubing, and 11 with reduction only, without fixation. In the last group, the hospital stay was the shortest. These patients had also less complications and roentgenological changes when compared with the other groups. This was considered to be due to the fact that fractures not requiring fixation are initially less difficult than fractures requiring other treatment. At clinical examination, internal wiring fixation proved to be better than antral packing when hospital stay, restoration of the function of the infra-orbital nerve, the position of the eye, symmetry of the palpebral fissure and the final cosmetic results are considered. In the antral packing group, the result was better when jaw movements and occurrence of permanent diplopia were compared. The roentgenological examination revealed that the reduction results were more exact with internal fixation than with antral packing.

Adolescent↗

PubMed1982

Blow-out fracture of the orbit. Diagnostic and therapeutic considerations, and results in 90 patients treated.

On the basis of 90 patients with blow-out fracture of the orbit the authors present diagnostic methods, the treatment and follow-up results, mainly as regards visual function (diplopia) and aesthetics (enophthalmos). Surgery was performed in 77 cases, 6 patients were treated conservatively by eye muscle training, and 7 patients refused surgery. Surgery consisted in primary reconstruction of the orbit, exploration of the fracture site, freeing the entrapped soft tissues (periorbital tissues, eye muscles) and reconstruction of the defect with autogenous bone graft, followed by eye muscle surgery in cases of failure. After surgery no complications were observed. Results of treatment were evaluated by established methods elaborated by the authors, in the same order before and after surgery. Of 77 patients treated surgically recovery was obtained in 63.6%, marked improvement in 23.4%, slight improvement in 13.0%. In conclusion the authors state that: 1) in all cases ophthalmological examination is most important, 2) approach to the orbital floor or medial wall is best obtained by transconjunctival or subciliary incision, 3) in cases with a defect with a defect of the orbital floor the best material is autogenous bone graft. In linear fracture of the orbital floor and medial wall it is sufficient to free the entrapped tissues, 4) in all surgical patients eye muscle training proved effective.

Adolescent↗

PubMed2001

Current neuro-ophthalmic therapies.

The clinical characteristics, differential diagnosis, and treatment options are presented for five different categories of neuro-ophthalmic disease. Nystagmus, optic neuritis, diplopia, pseudotumor cerebri, and temporal arteritis, are frequently encountered in neuro-ophthalmic practice. This article focuses on current therapies for these neuro-ophthalmic disorders. Potential differences in approach to pediatric versus adult patients are emphasized.

Adult↗

PubMed2002

Permanent blue discoloration of a hydrogel intraocular lens by intraoperative trypan blue.

A 79-year-old white man had cataract surgery in the right eye with implantation of an Acqua intraocular lens (IOL) (Mediphacos). Trypan blue 0.1% was used during surgery to stain the anterior capsule and enhance the contrast during capsulorhexis. Seven days after surgery, the patient presented with "dark and double" vision (monocular diplopia). The IOL was decentered superiorly and appeared dark blue. The lens was explanted 2 months after surgery and sent for gross and microscopic analyses in a dry state and after hydration. The same analyses were performed on 2 unused lenses of the same design that had been immersed in diluted trypan blue solutions (0.01% and 0.001%). On the explanted lens, the dark blue staining was denser in the optic, especially in its periphery. The blue discoloration could not be removed after 24 hours of lens immersion in a balanced salt solution at 37 degrees C. Permanent staining of the unused lenses was also obtained after immersion in the trypan blue solutions.

Aged↗

PubMed1996

Ocular deviation following excimer laser photorefractive keratectomy.

We present a case of ocular deviation and diplopia that developed 9 months after monocular excimer laser photorefractive keratectomy. In this case, decompensation occurred because of a breakdown of fusion at distance. We suggest a cover test to assess the presence of significant phorias in all candidates for refractive surgery procedures.

Cornea↗