Are We Missing Amblyopia? The Answer: Preschool Screening

PEDIATRICS ◽  
1977 ◽  
Vol 60 (4) ◽  
pp. 603-605
Author(s):  
Zane F. Pollard
Keyword(s):  
Visual Acuity ◽  
Prospective Study ◽  
Successful Treatment ◽  
Intensive Therapy ◽  
Common Finding ◽  
Conservative Estimate ◽  
Accurate Evaluation ◽  
Fellow Eye ◽  
Preschool Screening ◽  
A Prospective Study

Amblyopia is a reduced visual acuity in one eye that is not related to obvious structural or pathological anomalies.1 Most authors do not include organic causes of reduced vision such as cataract, retrolental masses, scarred cornea, chorioretinitis, and tumors in the group of patients having amblyopia. Visual acuity must be measured under monocular conditions. If a child is allowed to use his one normal eye while the visual acuity is measured, the amblyopia will go undetected. By carefully occluding one eye while the vision is measured in the fellow eye, an accurate evaluation is obtained. The diagnosis is made when there is at least a two-line difference in Snellen test types between the two eyes, e.g., 20/20 in one eye and 20/30 in the opposite eye. A conservative estimate has shown that at least 2% of the population has amblyopia.2 Amblyopia is a common finding in children with strabismus.3 If a child has strabismus, the parents and the pediatrician notice that something is wrong with the child's eyes. But, what about the child who has amblyopia and straight eyes? What percentage of children with amblyopia have straight eyes, and how can we be sure not to miss the diagnosis in these patients? The answer is early preschool screening. The earlier the amblyopia is detected, the better the prognosis for successful treatment and the shorter the duration of intensive therapy. A prospective study was carried out to determine what percentage of children with amblyopia have straight eyes. The results also show what percentage of patients with amblyopia might be missed if we check visual acuity only in children with strabismus.

Customised gold weight eyelid implantation in paralytic lagophthalmos

2008 ◽  
Vol 122 (10) ◽  
pp. 1088-1091 ◽  
Author(s):  
N Jayashankar ◽  
K P Morwani ◽  
M J Shaan ◽  
S R Bhatia ◽  
K T Patil
Keyword(s):  
Visual Acuity ◽  
Prospective Study ◽  
Study Design ◽  
Study Group ◽  
Upper Eyelid ◽  
Eyelid Closure ◽  
Gold Weight ◽  
One Year ◽  
A Prospective Study

AbstractGold eyelid implantation is widely considered the procedure of choice to reanimate the upper eyelid in paralytic lagophthalmos. Commercially supplied implants are not readily available in all places and are sometimes cumbersome to import.Objective:We aimed to devise a method whereby every surgeon performing gold eyelid implantation could have easy and quick access to the implant. Furthermore, we aimed to develop a means of creating an implant of the exact weight required for complete eyelid closure.Study design and setting:A prospective study was performed from 1997 to 2005 in a tertiary research hospital, involving 50 subjects requiring gold upper eyelid implantation and using the technique in question.Results:Only patients with a minimum follow up of one year were included in the study group. Symptoms improved in 96 per cent of subjects, who were able to dispense with eyedrops and eye ointments. Visual acuity improved in 92 per cent of patients. There were two extrusions amongst the early cases.Conclusion and significance:Customised gold eyelid implantation offers an alternative in regions where commercial implants are not easily obtained.

scholarly journals Short-term eplerenone for treatment of chronic central serous chorioretinopathy; a prospective study

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Hamid-Reza Moein ◽  
Lauren W. Bierman ◽  
Eduardo A. Novais ◽  
Carlos Moreira-Neto ◽  
Caroline R. Baumal ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Prospective Study ◽  
Central Serous Chorioretinopathy ◽  
Subretinal Fluid ◽  
Enhanced Depth Imaging ◽  
Short Term ◽  
Chronic Central Serous Chorioretinopathy ◽  
Therapeutic Trials ◽  
Imaging Optical Coherence Tomography ◽  
A Prospective Study

Abstract Background Increased mineralocorticoid activity is one of the plausible causes of chronic central serous chorioretinopathy (CSCR) and mineralocorticoid inhibitors such as eplerenone have been investigated as its potential therapy. This study investigates the short-term safety and efficacy of oral eplerenone in patients with chronic CSCR. Patients and methods Prospective study of 13 eyes of 13 patients with the diagnosis of chronic CSCR. All patients received eplerenone 50 mg/day for 4 weeks. Enhanced depth imaging optical coherence tomography (OCT) was obtained. Best corrected visual acuity (BCVA), and OCT parameters including sub retinal fluid (SRF), choroidal thickness (CT) and central macular thickness (CMT), were measured manually. Results The mean SRF height decreased slightly at 1-month follow-up as compared to baseline, but the change was not statistically significant (94.18 ± 17.53 vs. 113.15 ± 18.69; p = 0.08). Subfoveal CT and CMT was significantly reduced as compared to baseline (6.6% [p = 0.002] and 7.05% [p = 0.04], respectively). The BCVA did not change significantly (20/28 vs. 20/30 [p = 0.16]). Conclusion This study suggests that oral eplerenone may be used as a safe and potentially effective treatment in chronic CSCR, however there are minimal short-term effects on subretinal fluid or visual acuity therefore therapeutic trials longer than one month are necessary to test its benefits. Trial registration Clinicaltrials.gov identification number: NCT01822561. Registered 3/25/13, https://clinicaltrials.gov/ct2/show/study/NCT01822561

scholarly journals Thickness profiles of the corneal epithelium along the steep and flat meridians of astigmatic corneas after orthokeratology

2020 ◽  
Author(s):  
Jiaqi Zhou ◽  
Feng Xue ◽  
Xingtao Zhou ◽  
Rajeev Krishnan Naidu ◽  
Yishan Qian
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Prospective Study ◽  
Corneal Epithelium ◽  
Fourier Domain ◽  
Corneal Epithelial ◽  
Epithelial Thickness ◽  
Corneal Epithelial Thickness ◽  
A Prospective Study ◽  
Lens Wear

Abstract Background: To investigate the changes in corneal epithelial thickness along the principle meridians of astigmatic corneas after six months of overnight spherical myopic orthokeratology (OK) lens wear. Methods: A prospective study. Fifty-seven subjects with up to 1.50 diopters (D) of corneal toricity wore spherical OK lenses for 6 months. Evaluations of OK lens fit, visual acuity, refractions and corneal toricity (CT) were performed. Fourier-domain optical coherence tomography (FD-OCT) was conducted to measure the corneal epithelial thickness (ET) along the principle meridians of corneal toricity over a diameter of 6mm. The means of △ET of the same diameter at individual meridians (△ETSm and △ETFm) were calculated and compared. Results: Visual acuity and refraction improved significantly after OK lens wear. △ETFm (-4.2±3.4μm) thinned more than △ETSm (-3.4±4.0μm, P=0.027) at 1.5mm in radius. △ETSm thickened more than △ETFm at 2.5mm (△ETSm: 4.1±5.1μm, △ETFm: 2.8±4.2μm, P=0.019) and 3.0mm (△ETSm: 5.0±5.0μm, △ETFm: 3.7±4.9μm, P=0.036).∣△ETSm - △ETFm∣ were significantly correlated with the baseline central CT at 2.0mm, 2.5mm and 3.0mm (2.0mm: r=0.285, P=0.032; 2.5mm: r=0.422, P=0.001; 3.0mm: r=0.239, P=0.027). ∣△ETSm - △ETFm∣was significantly correlated with the baseline peripheral CT at 2.5mm (r=0.299, P=0.028). Conclusions: Overnight wear of spherical OK lenses resulted in differential changes in the thickness profiles of the corneal epithelium between the steep and flat meridians in eyes with corneal toricity.

EVALUATION OF THE EFFECTS OF ORTHOKERATOLOGY ON MYOPIA, ASTIGMATISM IN DA NANG FARGO ORTHO-K CENTER

2018 ◽  
Vol 8 (4) ◽  
pp. 70-75
Author(s):  
Khoi Hoang Huu
Keyword(s):  
Visual Acuity ◽  
Prospective Study ◽  
Key Words ◽  
Case Studies ◽  
Outcome Evaluation ◽  
Spherical Equivalent ◽  
Safe Treatment ◽  
Spherical Equivalent Refraction ◽  
Pre Treatment ◽  
A Prospective Study

Objectives: To evaluate the effects of orthokeratology (Ortho-K) on myopia, astigmatism and identify complications during applying the treatment. Methods: This is a prospective study accompanied with a series of case studies and outcome evaluation of 118 eyes of 60 patients who were diagnosed for myopia, astigmatism and were indicated wearing overnight Ortho-K lenses during the time from June 2017 to June 2018. Results: 118 eyes were prescribed wearing overnight Ortho-K lenses and their results were reported as follow: Visiual acuity ≥ 8/10 before the treatment was 1.7%, after one day of the treatment it increased to 3.4%, after 1 week it was 34.7%, after 1 month it was 71.2%, after 3 month it was 87.1% and after 6 months it accounted for 94.7%; Mean spherical equivalent refraction pre-treatment was -4.03D ± 1.70D, after 6 months of the treatment it reduced to - 0.38D ± 0.45D; Residual refraction after 6 months of the treatment ≤ 1.00D accounted for 96.5%; After 1 month of the treatment, 09 eyes (7.6%) were diagnosed for mild keratitis and 109 eyes (92.4%) had normal cornea after the treatment. Conclusions: Our results suggest that orthokeratology is a highly effective and safe treatment for correcting visual acuity in myopic and astigmatic patients. Key words: Myopia, astigmatism, orthokeratology

Who should treat epistaxis?

1987 ◽  
Vol 101 (2) ◽  
pp. 139-142 ◽  
Author(s):  
D. G. John ◽  
A. I. Alison ◽  
D. J. A. Scott ◽  
A. R. McRae ◽  
M. J. Allen
Keyword(s):  
Emergency Department ◽  
General Practitioner ◽  
Prospective Study ◽  
Successful Treatment ◽  
Successful Management ◽  
Bleeding Point ◽  
Accident And Emergency ◽  
Accident And Emergency Department ◽  
A Prospective Study

AbstractA prospective study was undertaken of 75 patients complaining of epistaxis who presented to an Accident and Emergency Department.The patients were placed into four groups according to their presenting features, and various forms of appropriate management applied.It was found that in the group that had ceased bleeding on presentation, whether or not a bleeding point was visible, there was no benefit obtained by treatment. If the nose was still bleeding on presentation, and the bleeding point was visible, successful management could be obtained by cauterising the bleeding point. This is a treatment that could be carried out by either the General Practitioner or the Accident Department. If the nose was actively bleeding, and the bleeding point could not be seen, then even initially successful treatment by the Accident Department was usually found to be ineffective within forty-eight hours. It is suggested that this group should be referred to an ENT unit on presentation.

scholarly journals MRI brain findings of cerebral malaria in children with acute encephalitis syndrome: a prospective study in 60 patients

2020 ◽  
Vol 8 (11) ◽  
pp. 4001
Author(s):  
Vibha Yadav ◽  
Sharad Thora ◽  
Prachi Choudhary
Keyword(s):  
Prospective Study ◽  
Cerebral Malaria ◽  
Common Finding ◽  
Age Group ◽  
Neuropsychological Dysfunction ◽  
Altered Sensorium ◽  
Mri Brain ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis ◽  
A Prospective Study

Background: Acute encephalitis syndrome (AES) is defined as a person of any age group, at any time of the year with the acute onset of fever and change in mental sensorium (including confusion, disorientation, coma or inability to talk) and/or new onset of convulsions (excluding febrile seizures). Encephalitis is a inflammation of brain tissue which presents as a diffuse and/or a focal neuropsychological dysfunction and inflammation of adjacent meningitis. Objectives were to determine clinicoepidemiological profile in AES with special to reference cerebral malaria and to study various MRI findings in patients of AES especially in cerebral malaria.Methods: A prospective study of all cases of fever with unconsciousness or altered sensorium with or without convulsions admitted in PICU of MYH and CNBC Indore. Inclusion criteria was all those children who were previously neurologically normal, of age 1-14 years, patients with fever (<15days) with altered sensorium, with or without seizures and who stay in hospital long enough to complete essential diagnostic work up which includes (CBC with peripheral smear, RFT, LFT, MP, S. electrolytes, CSF, MRI brain).Results: The final study group comprised of 60 patients with age group 1-14 yrs and male to female ratio was 1.07:1. Patients with diagnosis of cerebral malaria were 17. High grade fever, headache, altered sensorium, generalized seizures In general examination pallor was present in 52.9%, icterus in 35.29% cases of cerebral malaria. Splenomegaly (70.5%) was more common finding than hepatomegaly (58.8%) in cerebral malaria. GCS was>6 in most cases, fundus abnormality and meningeal irritation was absent in all cases of cerebral malaria. MRI of brain in cerebral malaria was mostly normal, in (47.05%), second most common we get hyperintensity in periventricular and corpus callosum areas (23.52%), hyperintensity in basal ganglia and thalamus was found in17.64% cases and white matter changes in 2 cases. The final outcome of all cerebral cases was good, all were discharged, and there was no mortality.Conclusions: Our result demonstrate that cerebral malaria is a common cause of acute febrile encephalopathy in children. Presence of plasmodium falciparum is essential for diagnosis of cerebral malaria. No specific lesions have been identified in MRI brain.  

scholarly journals The Impact of Electronic Reading Devices on Reading Speed and Comfort in Patients with Decreased Vision

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Henry L. Feng ◽  
Daniel B. Roth ◽  
Howard F. Fine ◽  
Jonathan L. Prenner ◽  
Kunjal K. Modi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Prospective Study ◽  
Reading Speed ◽  
Reading Performance ◽  
Convenience Sample ◽  
Electronic Reading ◽  
Printed Text ◽  
A Prospective Study ◽  
The Impact ◽  
Back Illuminated

Background/Aims. To evaluate the impact of back-illuminated and nonilluminated electronic reading devices on reading speed and comfort in patients with decreased vision. Methods. A prospective study involving a convenience sample of 167 patients at a single retina practice from January 2011 to December 2012. Participants were asked to read five different excerpts on five different media in a randomly assigned order. Media included a printed book at 12-point font (12PF), iPad2 at 12PF, iPad2 at 18-point font (18PF), Kindle2 at 12PF, and Kindle2 at 18PF. Reading speed in words per minute (WPM) and medium preference were recorded and stratified by visual acuity (VA). Results. Mean reading speeds in WPM: iPad2 at 18PF (217.0), iPad2 at 12PF (209.1), Kindle2 at 18PF (183.3), Kindle2 at 12PF (177.7), and printed book at 12PF (176.8). Reading speed was faster on back-illuminated media compared to nonilluminated media. Text magnification minimized losses in reading performance with worsening patient VA. The majority of participants preferred reading on the iPad2 at 18PF. Conclusions. Back-illuminated devices may increase reading speed and comfort relative to nonilluminated devices and printed text, particularly in patients with decreased VA.

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