Cerulean Cataract in a Person with Down s Syndrome

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Madbouhi K ◽  
◽  
Cherkaoui O ◽  
Keyword(s):  
Visual Acuity ◽  
Clinical Examination ◽  
Down's Syndrome ◽  
Anterior Segment ◽  
Down’S Syndrome ◽  
Congenital Form ◽  
The Right ◽  
Radial Arrangement ◽  
Loss Of Visual Acuity

We report the case of an 18-year-old patient who consults for a loss of visual acuity in the right eye for 1 year. On clinical examination, visual acuity is 20/100. Eye tone is 12 mmhg. Examination of the anterior segment shows the existence of a cataract made up of whitish opacities corresponding to a congenital cerulean cataract (Figure 1). The treatment consisted of a cataract cure by phacoemulsification with good progress. Cerulean cataract is a rare congenital form of bluish tint, made up of whitish opacities in concentric layers with a radial arrangement at their center. Visual acuity is fairly good in childhood but may deteriorate later. In the literature, the incidence of cataracts in Down’s children ranges from 5% to 50%. In previous studies of congenital or infantile cataract, 3-5 % of cases were associated with Down’s syndrome [1].

Visual acuity and accommodation in infants and young children with Down's syndrome

1996 ◽  
Vol 40 (1) ◽  
pp. 49-55 ◽  
Author(s):  
J. M. Woodhouse ◽  
V. H. Pakeman ◽  
K. J. Saunders ◽  
M. Parker ◽  
W. I. Fraser ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Young Children ◽  
Down's Syndrome ◽  
Down’S Syndrome ◽  
Infants And Young Children

scholarly journals Visual and refractive status of children with Down's syndrome and nystagmus

2021 ◽  
Author(s):  
Asma A A Zahidi ◽  
Lee McIlreavy ◽  
Jonathan T Erichsen ◽  
J Margaret Woodhouse
Keyword(s):  
Visual Acuity ◽  
Down's Syndrome ◽  
Down’S Syndrome ◽  
Research Unit ◽  
First Year ◽  
Published Data ◽  
Wide Range ◽  
Clinical Records ◽  
First Year Of Life ◽  
Refraction Data

Background/Aims: Children with Down's syndrome (DS) are known to have poorer visual acuity that neurotypical children. One report has shown that children with DS and nystagmus also have poor acuity when compared to typical children with nystagmus. What has not been established, is the extent of any acuity deficit due to nystagmus and whether nystagmus impacts on refractive error is within a population with DS. Methods: Clinical records from The Cardiff University Down's Syndrome Vision Research Unit were examined retrospectively. Binocular visual acuity and refraction data were available for 50 children who had DS and nystagmus (DSN) and 176 children who had DS but no nystagmus. Data were compared between the two groups, and with published data for neurotypical children with nystagmus. Results: The study confirms the deficit in acuity in DS, compared to neurotypical children, of approximately 0.2 LogMAR and shows a further deficit attributable to nystagmus of a further 0.2 logMAR beyond the first year of life. Children with DS and no nystagmus appear to have acuity that mirrors that of typical children with nystagmus, while children with both DS and nystagmus have a significant additional impairment. Children with DS have a wide range of refractive errors, but nystagmus increases the likelihood of myopia. Prevalence and axis direction of astigmatism, on the other hand appears unaffected by nystagmus. Conclusion: Nystagmus confers an additional visual impairment on children with Down's syndrome and must be recognised as such by families and educators. Children with both DS and nystagmus clearly need targeted support.

Cast aside

2021 ◽  
pp. 191-196
Author(s):  
Michael Obladen
Keyword(s):  
Trisomy 21 ◽  
Homo Sapiens ◽  
Down's Syndrome ◽  
Scientific Progress ◽  
Down’S Syndrome ◽  
Chromosomal Anomalies ◽  
Additional Chromosome ◽  
Ethnic Classification ◽  
The Right ◽  
Invasive Techniques

Trisomy 21 originated with Homo sapiens, or even before, as it exists in other primates. However, in antiquity, Down’s syndrome was rare: mothers were younger, and children failed to reach adulthood. For centuries, trisomy 21 and hypothyreosis were confused. Scientific reports originated from asylums for the mentally retarded. In 1866, John Langdon Down at Earlswood published a description of symptoms in his ‘Ethnic classification of idiots’ and coined the term ‘Mongolian’. Jerôme Lejeune identified an additional chromosome 21 causing the disorder. Maternal age rose markedly for various reasons, as did the prevalence of trisomy 21. From 1968, high-risk pregnancies were screened and interrupted because of Down’s syndrome. Non-invasive techniques now enable all pregnancies to be screened to detect chromosomal anomalies early and precisely. The topic is hotly debated and consensus unlikely. Legislation will not halt scientific progress, but it should ensure that in the same society contradictory attitudes can be held and mutually respected: the right to accept a disabled infant and the right not to accept it.

scholarly journals Photodynamic Therapy for Juxtapapillary Retinal Capillary Hemangioma

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Panagiotis G. Mitropoulos ◽  
Irini P. Chatziralli ◽  
Vasileios G. Peponis ◽  
Vasileia A. Tsiotra ◽  
Efstratios A. Parikakis
Keyword(s):  
Visual Acuity ◽  
Photodynamic Therapy ◽  
Optic Disc ◽  
Anterior Segment ◽  
Capillary Hemangioma ◽  
Treatment Modalities ◽  
Inferior Margin ◽  
Retinal Capillary ◽  
Retinal Capillary Hemangioma ◽  
The Right

Various treatment modalities have been described for retinal capillary hemangioma. Our purpose is to present a case of juxtapapillary retinal capillary hemangioma treated with photodynamic therapy. A 69-year-old woman with no previous ocular history presented with blurred vision and photopsias in the right eye three months ago. At presentation, her best corrected visual acuity was 6/9 in the right eye and 6/6 in the left eye. The anterior segment was totally normal and IOP was normal in both eyes as well. Dilated fundoscopy revealed a yellowish, well-circumscribed, elevated area with blood vessels, on the inferior margin of the right optic disc, as optic disc edema. Fluorescein angiography and angiogram with indocyanine green confirmed the diagnosis of juxtapapillary retinal capillary hemangioma. The patient was treated with photodynamic therapy with verteporfin and three months later her visual acuity was 6/7.5 in the right eye, while the lesion was slightly smaller. These findings remained stable at the one-year follow-up. In conclusion, photodynamic therapy offers promising anatomical and functional results for juxtapapillary retinal capillary hemangioma, providing visual acuity improvement or even stabilization and restriction of enlargement of the lesion.

The influence of intellectual disability on longitudinal arching and symmetry of lateral and medial load of the foot

2019 ◽  
Vol 6 (1) ◽  
pp. 29-34
Author(s):  
Marta Bibro ◽  
Agnieszka Jankowicz-Szymańska ◽  
Katarzyna Wódka ◽  
Małgorzata Łaczek-Wójtowicz
Keyword(s):  
Intellectual Disability ◽  
Intellectual Disabilities ◽  
Down's Syndrome ◽  
Down’S Syndrome ◽  
Control Group ◽  
Functional Efficiency ◽  
Flat Feet ◽  
People With Intellectual Disabilities ◽  
The Right ◽  
The Impact

Background: In the population of people with intellectual disabilities (ID) there is a frequent occurrence of bone deformities and orthopedic problems affecting the feet as well. They are associated with a change of the loading of the feet. It affects the deterioration of the functional efficiency of the feet, often contributes to discomfort, pain and predisposes to the development of adverse changes in the upper body segments. The aim of the study was to assess the impact of intellectual disability in participants with aetiology other than Down’s syndrome on longitudinal arching and symmetry of lateral and medial load of the foot. Materials and methods: There were 38 participants with mild and moderate intellectual disability, with an average age of 23 years and 44 young non-disabled people with an average age of 20.8 under research. The main measurement tool used to assess the arching and loading the foot zones was the BTS P-WALK platform. The measurement included analysis in terms of statics and lasted 30s. Results: The comparison of both groups showed no significant differentiation in the medial and lateral load of the forefoot and rearfoot. Among people with ID correct arches of the feet were observed in 52.6% of participants in the right foot and 57.9% of the left foot, while in the control group in 56.9% in both the right and left foot. People with intellectual disabilities were characterized by a higher rate of flatfoot in relation to the control group. The hollow foot was more frequently observed in control group than in people with ID. Conclusions: In people with intellectual disabilities with aetiology other than Down’s syndrome, flat feet are diagnosed more often than in healthy peers who do not differ in body weight and BMI. Intellectual disability is associated with a greater loading of the medial part of the forefoot.

Ageing in Down's Syndrome

1985 ◽  
Vol 147 (1) ◽  
pp. 58-62 ◽  
Author(s):  
K. E. Hewitt ◽  
G. Carter ◽  
J. Jancar
Keyword(s):  
Visual Acuity ◽  
Hearing Loss ◽  
Down's Syndrome ◽  
Down’S Syndrome ◽  
Psychological Testing ◽  
Physical Illness ◽  
Chronological Age ◽  
Neurological Signs ◽  
Mental Age ◽  
Hospital Patients

SummaryIn a group of 23 hospital patients aged over 50 with Down's syndrome, psychological testing indicated that significant intellectual deterioration, which was un-related to chronological age, sex, length of hospitalisation, or earlier mental age, had occurred in nine. Clinically, there was no evidence in any patient of active physical illness, focal neurological signs, or dementia, but significant associations were found between intellectual deterioration and decreased visual acuity, hearing loss, and macrocytosis.

scholarly journals Case Report of Myopia Correction by ReLEx SMILE in a Patient with Superficial Corneal Opacity

2020 ◽  
Vol 17 (2) ◽  
pp. 295-299
Author(s):  
N. V. Maychuk ◽  
I. A. Mushkova ◽  
A. M. Mayorova ◽  
A. A. Shpak
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Anterior Segment ◽  
Corneal Opacity ◽  
Optical Center ◽  
Interface Zone ◽  
Uncorrected Visual Acuity ◽  
Corneal Opacities ◽  
Different Depths ◽  
The Right

Introduction. Reduced corneal transparency leads to dissipation of energy of the femtosecond laser (FSL), which may complicate the formation of the intrastromal incision and limits the use of FSL in eyes with corneal opacities and scars. The purpose of this work is to demonstrate the possibility of successful ReLEx SMILE in a patient with superficial corneal opacity located in the paracentral zone. Case report. Patient R., 29 years old, complained of decreased vision in both eyes since childhood. Visual acuity OD = 0.1 sph –2.75D = 1.0; OS = 0.1 sph –3.50 D cyl –0.75D ax 165° = 1.0. Biomicroscopy of the right eye visualized a superficial semi-transparent corneal opacity of 5 x 3 mm located at 5.30–6 hours at a distance of 1.3 mm from the optical center. According to the anterior segment optical coherence tomography (AS-OCT) the depth of the opacity was 73–78 microns and was limited by the Bowman’s membrane. ReLEx SMILE for myopia correction was performed on both eyes with 6.7 mm lenticule diameter at a depth of 120 µm, which covered the opacity area by 1.1 mm. The surgery was standard and uncomplicated. Seven days postoperatively the patient did not complain. Uncorrected visual acuity (UCVA) was 1.0 for both eyes (and binocularly it was 1.2). According to the AS-OCT data, a hyperreflective line of the interface zone was visualized on the right eye at the depth of 141–147 µm; the opacified superficial corneal layers were detected in the lower paracental zone over the interface line. In one month after the surgery the visual acuity did not change: UCVA = 1.0 in both eyes (binocularly 1.2). Conclusion. ReLEx SMILE technology can be considered as one of the options for myopia correction in patients with superficial corneal opacity located in the paracental zone. More observations are required to evaluate the effectiveness of this technology on corneas with paracentral opacities different in sizes and located at different depths.

scholarly journals Optic nerve and retinal damage in a patient with post-hemorrhagic anemia

2015 ◽  
Vol 96 (6) ◽  
pp. 1074-1078
Author(s):  
E E Grishina ◽  
A A Ryabtseva ◽  
T V Belova ◽  
O M Andryukhina
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Iron Deficiency ◽  
Gastrointestinal Bleeding ◽  
Blood Vessels ◽  
Clinical Examination ◽  
Hemoglobin Level ◽  
Retinal Damage ◽  
Field Of Vision ◽  
The Right

There is a number of literature data on ischemic optic neuropathy development in acute hemorrhage. However, ocular disorders in prolonged chronic hemorrhage and iron-deficiency anemia are not well studied. We present a clinical case of optic nerve and retinal damage in a patient with prolonged chronic gastrointestinal bleeding. 53-year-old patient S. presented with complaints on dramatic sudden loss of vision of his right eye (visual acuity was 0/02 and was not improving with correction). Visual acuity of the left eye was good. Ophthalmoscopy revealed right optic nerve swelling, flame-shaped disc and peripapillary hemorrhages, and multiple soft exudates along blood vessels of the right eye. Optic nerve head of the left eye was pale pink, with well-defined borders. Multiple soft exudates along blood vessels and few flame-shaped hemorrhages were identified as well. Clinical examination revealed iron-deficiency post-hemorrhagic anemia. The diagnosis of anterior ischemic neuropathy of the right eye, ischemic neuroretinopathy of left eye associated with post-hemorrhagic anemia was established. Conservative treatment increased hemoglobin level up to 82 g/l, the red blood cells count - up to 2,88×1012/L, hematocrit was 0.25%, platelet count reached 344×109/L, but the signs of rectal bleeding remained. The patient underwent surgery for hemorrhoids. After the increase of hemoglobin level, visual acuity of the right eye improved to 0.1, the visual acuity of the left eye was 1.0. According to the results of computed peripheral vision test (Humphrey Full Field 120 Point Screening Test), central scotoma and scotomas in the lower half of the field of vision of the right eye remained. In the field of vision of the left eye, the area of absolute arcuate scotoma in the lower-nasal quadrant decreased significantly. Reduced visual acuity was the main complaint of the patient with a longstanding gastrointestinal bleeding. A careful history and thorough clinical examination allowed to establish the cause of the optic nerve and retinal damage, to assign pathogenetically based treatment, which led to an improvement in visual function.

Two-year successful results of femto-LASIK in steep and opacified corneas

2020 ◽  
Vol 1 (1) ◽  
pp. 37-43
Author(s):  
Amr Mounir ◽  
Emad Latif Matthias ◽  
Islam Awny
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Intraoperative Complications ◽  
Anterior Segment ◽  
Laser In Situ Keratomileusis ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Refractive Correction ◽  
Corneal Opacities ◽  
The Right

  Background: Flap creation is the most critical step of laser in situ keratomileusis (LASIK). The introduction of the femtosecond laser with its uniform flaps, which enhance the accuracy of LASIK, has decreased the risk of flap-related complications like buttonholes and incomplete flaps. We recommended femtosecond laser-assisted LASIK (FS-LASIK) in the presence of superficial corneal opacities. Case Presentation: We report a case of a 31-year-old female who reported to the Cornea clinic of the Sohag Center for LASIK and Corneal Surgeries, Sohag, Egypt, complaining of bilateral decreased vision due to refractive error. The uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were 0.01 and 0.7 with a refractive correction of -3.50Ds/ –3.00Dc x 172° in the right eye and 0.01 and 0.6 with a refractive correction of -1.75 Ds/-6.00Dc x164° in the left eye, respectively. Slit-lamp examination of the anterior segment showed bilateral superior vascularized corneal scars and a linear superior conjunctival scar suggestive of old trachoma. Corneal tomographic imaging with a Scheimpflug based tomography device (Oculus Inc., Wetzlar, Germany) revealed a symmetrical bow tie with a very steep cornea without other ectatic changes. The patient underwent bilateral FS-LASIK with an excimer laser. No intraoperative complications occurred. She was followed up for two years with serial corneal topographies and stable post-LASIK results and visual outcomes. Conclusions: FS-LASIK, in the presence of superficial corneal opacities, was safe and effective and induced no complications with special precautions. However, these findings are yet to be confirmed using well‐designed clinical studies with larger samples and longer follow-ups.

scholarly journals Optic neuropathy due to allergic fungal rhinosinusitis

2011 ◽  
Vol 02 (02) ◽  
pp. 180-182 ◽  
Author(s):  
Jiji Tresa Cyriac ◽  
Tambi Cherian ◽  
Wasna Ali Hadi ◽  
Joyce Jose
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Anterior Segment ◽  
Sinus Surgery ◽  
Automated Perimetry ◽  
Blurred Vision ◽  
Eye Color ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
The Right

ABSTRACTAn uncommon case of allergic fungal rhinosinusitis presented to the ophthalmology outpatient department of our hospital with complaints of blurred vision in the right eye of a few days duration and vague complaints of pain around the eyes. The visual acuity on examination was grossly reduced in the right eye and normal in the left eye. Color vision was normal. Anterior segment examination including pupils was normal. Dilated fundus examination was normal except for temporal pallor in the right optic disc. Automated perimetry and magnetic resonance imaging (MRI) scan of brain and orbit were done. The imaging report showed a bilateral pansinusitis with pressure on the right optic nerve. Perimetry showed a superior field defect on the right side. ENT consultation and computed tomography (CT) with contrast helped to diagnose this as a case of allergic fungal rhinosinusitis. The patient was started on systemic steroids under the care of the ENT surgeon. After a few days, pre-operative assessment showed a gross improvement of visual acuity. Endoscopic sinus surgery was done to remove the polyps and thick mucus material. Histopathologic examination confirmed allergic fungal mucin. Days after surgery, the visual acuity improved further and repeat perimetry showed gross improvement in the visual field. Good history taking and a detailed ophthalmic examination, keeping in mind the probable causes of loss of vision of few days duration with no findings other than a decreased visual acuity and a suspicious disc, were key to the early diagnosis and investigation in this case. This helped in early referral and management of the case before permanent damage and irreversible visual loss occurred. The optic nerve is a cranial nerve which, once damaged permanently, will not regenerate. The amount of sinus involvement was extensive on both sides and invariably the left optic nerve would have been involved in a few days, if intervention was delayed.

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