scholarly journals Pupillotonia and Adie Syndrome

2020 ◽  
Vol 76 (5) ◽  
pp. 232-235
Author(s):  
Kristína Horkovičová ◽  
Ivajlo Popov ◽  
Jela Valášková
Keyword(s):  
Local Therapy ◽  
Emergency Admission ◽  
Ophthalmological Examination ◽  
Know How ◽  
Pupil Function ◽  
Intraocular Tumors ◽  
Department Of Ophthalmology ◽  
Reflex Arc ◽  
Close Range ◽  
Adie's Syndrome

The aim of the work is to approach the examination of the pupil with a focus on anisocoria, its characteristics and approach to the diagnosis of pupillotonia and Adie's syndrome and its clinical evaluation. Pupil function is important not only in neurophthalmological examination but also in general ophthalmological examination. First of all, we need to know how the reflex arc works in order to be able to exclude or confirm whether the parasympathetic or sympathetic is affected. It is also necessary to know the exact characteristics of the pupil, such as size, shape, placement, function and reaction to light and at close range. Only on this basis can we distinguish pathological features. We do not often encounter this diagnosis, but it is necessary to keep it in mind, especially in the field of neurophthalmology but also in general ophthalmology. We also present three cases of pupilotonia and Adie's syndrome, which we diagnosed at the Department of Ophthalmology, Faculty of Medicine, Comenius University, after the patient himself came by emergency admission or was sent directly to ophthalmology clinic. In the discussion, we present various other diagnoses, where the reflex arc may not be affected, but the pathological pupil is caused by intraocular tumors, general systemic diseases and, last but not least, local therapy or alkaloids.

Ophthalmic Care in Nursing Homes for the Blind: A Growing Challenge

2020 ◽  
Vol 237 (11) ◽  
pp. 1326-1333
Author(s):  
Helena Wagner ◽  
Julia Stifter ◽  
Diana Engesser ◽  
Lisa Atzrodt ◽  
Paola Kammrath Betancor ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Visually Impaired ◽  
Medical Center ◽  
Local Therapy ◽  
Age Related Macular Degeneration ◽  
Ophthalmological Examination ◽  
Data Set ◽  
Blind And Visually Impaired ◽  
Age Related ◽  
Set Up

Abstract Background The demographic change in Germany will lead to an increase in irreversible age-related eye diseases. This will increase the need for specialised care facilities for visually impaired people. Due to reduced mobility, residents in such facilities often do not receive adequate ophthalmological care. New concepts must therefore be considered for this group of patients. One approach is to set up an ophthalmological examination unit within the facility combined with regular visits by an ophthalmologist. We now present the experience with such a model in a home for the blind. Patients and Methods The project was initiated in 2009. Since then there have been visits by medical staff of the Eye Center at Medical Center, University of Freiburg, every two weeks. All patient records (2010 – 2017) were reviewed systematically. The following data were extracted in a structured and anonymous way: Age at first presentation, gender, ophthalmological diagnoses and if a therapy was initiated. This data set was finally analysed descriptively. Results Out of 130 residents aged between 48 and 100 years, half were between 78 and 90 years old. The youngest resident was 48, the oldest 100 years old. The median visual acuity was 0.2. Sixty percent of the residents had at least mild visual impairment according to the WHO (visual acuity < 0.5; category 1 – 6). In one of 6 – 7 residents, visual acuity could not be determined using Snellen charts. The most frequent ophthalmological diagnoses included cataract (44%), age-related macular degeneration (36%) and glaucoma (29%). In 67 residents (52%), the ophthalmological examination lead to treatment, such as application of local therapy or planning an operation. Conclusion In every second resident, the ophthalmologistʼs visit lead to treatment during the observation period. This underlines the difficulty of providing ophthalmological care even in specialised institutions for the blind and visually impaired, which is possibly due to the residentsʼ mobility problems. The concept presented here has established a low-threshold, sustainable and high-quality ophthalmological service on site. These positive experiences indicate that corresponding measures may also be useful for other locations. However, in order to implement such a project on a larger scale, suitable financing and accounting modalities for the construction measures, the nursing staff and the ophthalmological procedure still need to be developed.

scholarly journals The eye status in patients after new coronavirus infection

2020 ◽  
Vol 48 ◽  
pp. 20-26
Author(s):  
A. A. Ryabtseva ◽  
E. E. Grishina ◽  
O. M. Andryukhina ◽  
A. A. Kovrizhkina ◽  
A. S. Andryukhina
Keyword(s):  
Clinical Manifestations ◽  
Color Perception ◽  
Rapid Progression ◽  
Light Sources ◽  
Ophthalmological Examination ◽  
Dry Eyes ◽  
Department Of Ophthalmology ◽  
Coronavirus Infection ◽  
Fluorescence Contrast ◽  
Auto Fluorescence

Rationale: The emerging new coronavirus infection caused by SARS-CoV-2 has resulted in a pandemic. Its clinical manifestations are highly variable and the death rate is high due to rapid progression to acute respiratory distress syndrome. Identified abnormalities of the eye are mainly related to conjunctival injury during manifestation of the disease.Aim: To study the eye abnormalities in patients who have undergone COVID-19.Materials and methods: Ophthalmological examination was performed in 23 patients (6 [26%] men and 17 [74%] women, median age 42.39 years) at days 44 to 85 after manifestation of COVID-19 infection in the Department of Ophthalmology, MONIKI. In addition to the standard ophthalmological examination, all patients were evaluated with optical coherence tomography (OCT), auto fluorescence, contrast and color sensitivity test with different light sources, and tear production assessment.Results: In the late convalescence period there were complaints of dry eyes and abnormal color perception, with visual acuity being unchanged. The OCT assessment the peripapillary retina identified small hyper-reflective foci in the inner layers.Conclusion: Eye disease in patients after COVID-19 is mainly related to the condition of the eye surface, abnormal color perception and abnormal architectonics of the inner retinal layers, which can persist for a long time during convalescence.

scholarly journals Challenges in Patients with Trisomy 21: A Review of Current Knowledge and Recommendations

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Jennifer Robinson ◽  
Manca Tekavčič Pompe ◽  
Christina Gerth-Kahlert
Keyword(s):  
Literature Review ◽  
Trisomy 21 ◽  
Chart Review ◽  
Current Knowledge ◽  
University Hospital ◽  
Ophthalmological Examination ◽  
International Survey ◽  
Ocular Abnormalities ◽  
Common Diagnosis ◽  
Department Of Ophthalmology

Purpose. To summarize and review the common ophthalmic anomalies in children with trisomy 21 (Down syndrome) in order to propose an update to current clinical recommendations. Methods. A retrospective chart review, systemic literature review, and international survey of the frequency of ocular abnormalities, screening schedules, and challenging aspects examining children with trisomy 21. The chart review included patients treated at the Department of Ophthalmology at the University Hospital of Zurich over a two-year period. The international survey was submitted to the members of the Swiss Society of Ophthalmology, Slovenian Ophthalmological Society, and European Pediatric Ophthalmology Society. Results. Analysis of 52 patient records during the study period revealed refractive errors (astigmatism: 54% of patients, hyperopia: 26%, and myopia: 15%) as the most common diagnosis, whereas childhood cataract was reported in 5%. This is in concordance with the extended literature review of 249 publications, although congenital cataracts were reported to be higher than at our institution. The survey participants reported great challenges in taking care of these patients, despite their long professional experience (73% with over 10 years of experience). Conclusion. Care and treatment of children with trisomy 21 continues to be demanding for paediatric ophthalmologists. We recommend the following examination schedule for these patients: first, ophthalmological examination at 6–12 months of age, then once in 3–6 months for children under 2 years of age, once in 6 months for children 2–5 years of age, annually for children 5–10 years of age, and thereafter, to be decided on an individual basis depending on the presenting ocular abnormalities of the patient.

scholarly journals 25G Ultrasonic Vitrectomy in Surgical Treatment of Idiopathic Macular Hole

2019 ◽  
Vol 9 (3) ◽  
pp. 229-233
Author(s):  
B. M. Aznabaev ◽  
T. I. Dibaev ◽  
T. N. Ismagilov
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Professional Education ◽  
Vitreous Body ◽  
Treatment Technique ◽  
Ophthalmological Examination ◽  
Idiopathic Macular Hole ◽  
Visual Functions ◽  
Gas Tamponade ◽  
Department Of Ophthalmology

Introduction. Idiopathic macular hole (IMH) is a frequent disorder of the posterior segment of the eye that impacts on visual functions leading to the reduction of visual acuity and the manifestation of metamorphopsia. In the majority of cases the basic treatment technique for IMH is a three-port transconjunctival guillotine vitrectomy. In the key of the further development of vitrectomy the latest and most interesting is the use of ultrasonic energy for vitreous fragmentation. Members of staff of the Department of Ophthalmology with the Course of Additional Professional Education of Bashkir State Medical University jointly with the Department of Microsurgical Equipment of CJSC Optimedservice have built a 25G ultrasonic vitrectomy system with the mechanism of action that turns the vitreous body into easy-to-remove emulsion with the use of ultrasound.Materials and methods. This paper presents a clinical case of idiopathic macular hole successfully treated with the method of 25G subtotal ultrasonic vitrectomy.Results and discussion. The data obtained through comprehensive ophthalmological examination and supported by fundus-camera, OCT and OCTA images made it possible to make a diagnosis of vitreomacular traction syndrome, idiopathic macular hole, J. D. Gass stage 3. 25G subtotal ultrasonic vitrectomy was performed on the universal ophthalmic surgery system Optimed Profi (Optimedservice, Russia) with intraoperative OCT-controlled internal limiting membrane staining and peeling, and apposition of the macular hole edges with gas tamponade. A good outcome, both anatomical and functional, was achieved; IMH has closed and a positive visual acuity dynamic has been recorded.Conclusion. We can thus conclude that 25G subtotal ultrasonic vitrectomy with ILM peeling and gas tamponade is an effective IMH treatment method that ensures high visual functions.

scholarly journals DIGITAL PHOTOGRAMMETRY AS A RESOURCE FOR CUBAN CULTURAL HERITAGE: EDUCATIONAL EXPERIENCES AND COMMUNITY ENGAGEMENT WITHIN THE INNOVA CUBA PROJECT

2018 ◽  
Vol XLII-5 ◽  
pp. 37-44
Author(s):  
G. Tucci ◽  
A. Conti ◽  
L. Fiorini ◽  
F. Mei ◽  
E. I. Parisi
Keyword(s):  
Cultural Heritage ◽  
Local Community ◽  
Laser Scanner ◽  
Educational Process ◽  
Development Cooperation ◽  
Training Experience ◽  
Know How ◽  
Natural Progression ◽  
Close Range ◽  
University Of Florence

<p><strong>Abstract.</strong> The Laboratory of Geomatics for Environment and Conservation of Cultural Heritage (GECO &amp;ndash; University of Florence) has been involved since 2011 in a process of technological transfer in collaboration with the <i>Oficina del Historiador de La Ciudad de La Habana</i> (OHcH). The know-how transfer concerning geomatics techniques for documentation and surveying of cultural heritage is of fundamental interest for the principal Institution designated to the protection of Havana historical centre. The first project (2011&amp;ndash;2014) was mainly focused on the formation of specialized technicians from OHcH in the use of Terrestrial Laser Scanner (TLS), for documentation purposes of monumental and architectonical heritage. The ongoing project, INNOVA CUBA &amp;ndash; “International and intersectoral intervention for the safeguard of the cultural heritage of the country” started in 2017, is funded by AICS &amp;ndash; Italian Agency for Development Cooperation and coordinated by ARCS &amp;ndash; Culture Solidali.</p><p> The introduction of digital close-range photogrammetry represents the natural progression of this educational process, thus implementing the range of innovative surveying technologies available, in terms of instruments, software and technical know-how. The two-weeks training experience in Havana (2018) provided the participants, technical staff from OHcH and other institutions, all the necessary knowledge to be autonomously able to choose the suitable surveying technique, depending on object characteristics and on available devices, to correctly plan the survey and evaluate its metric quality. A final workshop, for a wider audience, was the opportunity to introduce future crowdsourcing photogrammetric activities, to improve the sensitivity and engagement of local community towards heritage protection and valorisation processes.</p>

scholarly journals PROFILE OF PATIENTS OF GLAUCOMA IN JAMMU PROVINCE (A HOSPITAL BASED STUDY)

2019 ◽  
Vol 3 (10) ◽  
Author(s):  
Angli Manhas ◽  
Rameshwar S Manhas ◽  
Gaurav S Manhas ◽  
Dinesh Gupta
Keyword(s):  
Optic Nerve ◽  
Tertiary Care ◽  
Nerve Fibers ◽  
Topical Steroids ◽  
Ophthalmological Examination ◽  
Care Hospital ◽  
Age Group ◽  
Loss Of Vision ◽  
Number Of Patients ◽  
Department Of Ophthalmology

Background: Glaucoma comprises group of disorder which cause damage to the ganglion cells and optic nerve fibers resulting in permanent loss of vision. Glaucoma is a silent killer of vision, the only treatable factor is IOP which can be lowered by medical means, laser treatment or surgery. Objectives: The objective of the study was to see profile of patients of glaucoma in jammu province. Material and method: The present prospective study involved 200 patients was conducted in the out-patient department of ophthalmology at tertiary care hospital of North India. After meeting inclusion & exclusion crieteria the patients underwent detailed clinical history, general examination, complete ophthalmological examination including dilated fundus examination, intra ocular pressure measurement, gonioscopy etc was done to diagnose different types of glaucoma. Results: Maximum number of patients i.e.128 were seen in age group of ≥50yrs followed by 60 in 41-50 yrs. Males i.e. 127 outnumbered females in present study. Total of 139 were from rural area. Maximum patients complain of diminution of vision ie 180 followed by pain in 135. Vision of 6/24-6/18 i.e. 59 (R/E) & 57 (L/E) followed by PL to <6/60 in 48(R/E) & 47(L/E) patients whereas PL absent was seen in 12 patients. Gonioscopically angle was open in 172(R/E) & 174(L/E) patients. Total of 102 patients had POAG. Conclusion: From present study we may conclude that glaucoma problem was more common in elderly age group and in males. It can lead to loss of vision among patient who suffer extreme optic nerve damage without realizing it. Therefore, for everybody above the age of 40years, it is mandatory to have IOP checked once a year especially if there is any risk factor for glaucoma like diabetes mellitus, myopia, family history of glaucoma, prolonged use of topical steroids etc. Keywords: Glaucoma, Gonioscopy, Intraocular Pressure(IOP), Visual acuity.

scholarly journals Unilateral lattice corneal dystrophy in a young female: A unique case report

2017 ◽  
Vol 9 (1) ◽  
pp. 66-69
Author(s):  
Anuradha Raj ◽  
Renu Dhasmana ◽  
Harsh Bahadur
Keyword(s):  
Corneal Opacity ◽  
Corneal Dystrophy ◽  
Young Female ◽  
Ophthalmological Examination ◽  
Lattice Corneal Dystrophy ◽  
Department Of Ophthalmology ◽  
Female Case ◽  
Temporal Quadrant ◽  
Lattice Pattern ◽  
Noncontact Tonometry

Background: Unilateral lattice corneal dystrophy is a rare entity. Objective: To highlight the evidence of unilateral lattice corneal dystrophy in a young female. Case: A young 28 years old female presented to the outpatient department of Ophthalmology with slowly progressive diminution of vision in left eye for one month. On ophthalmological examination best corrected visual acuity (BCVA) was 20/20 and 20/40 with refractive error of plano and -0.75D Cyl @30 for right and left eye respectively. Ocular examination of right eye was unremarkable. On slit lamp examination, left eye showed multiple radial lattice lines in branching spider like pattern in the temporal cornea with pupillary margin involvement. The lattice pattern was confined to anterior to midstroma of the cornea with intact epithelium and unremarkable endothelium. The lesions did not involve the limbus. These lattice lines were prominent on retroillumination. In temporal quadrant near pupillary margin a small radial nebulomacular corneal opacity was seen without any corneal vascularisation or edema. The anterior chamber was deep and quiet. Corneal sensations were markedly reduced. Intraocular pressure was 10 and 12mmHg for right and left eye respectively with noncontact tonometry. Fundus examination was unremarkable. Family history and systemic history was negative. Optical coherence tomography(OCT) showed hyperreflective material in midstoma confirmed the diagnosis of unilateral lattice corneal dystrophy(LCD) with an apparently healthy fellow eye. 

scholarly journals OCT-angiography: Regional reduced macula microcirculation in ocular hypertensive and pre-perimetric glaucoma patients

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246469
Author(s):  
Bettina Hohberger ◽  
Marianna Lucio ◽  
Sarah Schlick ◽  
Antonia Wollborn ◽  
Sami Hosari ◽  
...  
Keyword(s):  
Fixed Effects ◽  
Ganglion Cells ◽  
Open Angle Glaucoma ◽  
Retinal Nerve Fibre Layer ◽  
Oct Angiography ◽  
Foveal Avascular Zone ◽  
Ophthalmological Examination ◽  
Retinal Ganglion ◽  
Department Of Ophthalmology ◽  
Capillary Plexus

Purpose OCT-angiography (OCT-A) offers a non-invasive method to visualize retinochoroidal microvasculature. As glaucoma disease affects retinal ganglion cells in the macula, macular microcirculation is of interest. The purpose of the study was to investigate regional macular vascular characteristics in patients with ocular hypertension (OHT), pre-perimetric primary open-angle glaucoma (pre-POAG) and controls by OCT-A in three microvascular layers. Material and methods 180 subjects were recruited from the Erlangen Glaucoma Registry, the Department of Ophthalmology, University of Erlangen and residents: 38 OHT, 20 pre-POAG, 122 controls. All subjects received an ophthalmological examination including measurements of retinal nerve fibre layer (RNFL), retinal ganglion cell layer (RGC), inner nuclear layer (INL), and Bruch’s Membrane Opening-Minimum Rim Width (BMO-MRW). Macular vascular characteristics (vessel density, VD, foveal avascular zone, FAZ) were measured by OCT-A (Spectralis OCT II) in superficial vascular plexus (SVP), intermediate capillary plexus (ICP), and deep capillary plexus (DCP). Results With age correction of VD data, type 3 tests on fixed effects showed a significant interaction between diagnosis and sectorial VD in SVP (p = 0.0004), ICP (p = 0.0073), and DCP (p = 0.0003). Moreover, a significance in sectorial VD was observed within each layer (p<0.0001) and for the covariate age (p<0.0001). FAZ differed significantly between patients’ groups only in ICP (p = 0.03), not in SVP and DCP. For VD the AUC values of SVP, ICP, and DCP were highest among diagnostic modalities (AUC: 0.88, 95%-CI: 0.75–1.0, p<0.001). Conclusion Regional reduced macula VD was observed in all three retinal vascular layers of eyes with OHT and pre-POAG compared to controls, indicating localized microvascular changes as early marker in glaucoma pathogenesis.

scholarly journals Betaxolol, Brimonidin and Carteolol in the Therapy of Normal-Tension Glaucoma

2020 ◽  
Vol 76 (2) ◽  
pp. 94-97
Author(s):  
Ján Lešták ◽  
Martin Fůs ◽  
Iveta Weissová ◽  
Klára Marešová
Keyword(s):  
Visual Field ◽  
Neurological Disorders ◽  
Visual Fields ◽  
Local Therapy ◽  
Normal Tension Glaucoma ◽  
Visual Field Defects ◽  
Ophthalmological Examination ◽  
Clinical Value ◽  
Local Side ◽  
Therapy Treatment

Purpose: The purpose of the study was to evaluate influence of betaxolol, brimonidine and carteolol in the progression of the visual field defects during time at patients with normotensive glaucoma (NTG). Materials and methods: This study included (60 eyes of) 30 patients with NTG. First group consisted of 20 eyes of 10 patients of the average age of 58.5 years, who were treated by betaxolol. Second group also consisted of 20 eyes of 10 patients of the average age of 62.6 years and they were treated by brimonidine. Third group had the same count of the eyes and patients, the average age was 61.1 years and these patients were treated by carteolol. Diagnose of NTG was based on the comprehensive ophthalmological examination including electroretinography and visual evoked potentials. Visual fields were examined by fast threshold glaucoma test using Medmont M700 device. We compared pattern defect (PD) in the visual field for 3 years. The including criteria were: similar visual field findings at the beginning of the study, stable eye therapy (treatment was not changed during the study), uncorrected or best corrected (up to +-3 D) visual acuity of 1,0 of ETDRS, intraocular pressure between 10-15 mm Hg, if present, then compensated cardiovascular disease, no other internal or neurological disorders. Results: We didn’t notice any statistically important difference of PD. The study revealed that brimonidin (p=0,99) and betaxolol (p = 0,81) had the best effect. Conclusion: Local therapy of betaxolol, brimonidine and carteolol has an essential clinical value in normotensive glaucoma. All the mentioned treatments had a protective effect on the visual field. However, local side-effects of brimonidinu are a question.

scholarly journals Visual outcomes and intraoperative complications of small incision cataract surgery performed by junior residents in GMC

2022 ◽  
Vol 7 (4) ◽  
pp. 687-690
Author(s):  
Vishaka Naik ◽  
Ugam P .S Usgaonkar
Keyword(s):  
Intraoperative Complications ◽  
Ophthalmological Examination ◽  
Small Incision Cataract Surgery ◽  
Supervised Training ◽  
Department Of Ophthalmology ◽  
Peribulbar Anesthesia ◽  
Low Levels ◽  
Junior Residents ◽  
Anterior Capsulotomy ◽  
Better Than

To evaluate in intraoperative complications of MSICS performed by Junior Residents and to compare the incidences of major complications in the first six months of training versus last six months of training.It is a retrospective type of study. From March 2018 to February 2019 a total of 293 manual SICS were conducted by the Junior Residents in Department of Ophthalmology. Each of the patients underwent a detailed ophthalmological examination preoperatively and underwent MSICS under peribulbar anesthesia. Consents for surgeries were obtained from each patient.Following intraoperative complications were noted: tunnel related complications, capsulorrhexis related complications, Iridodialysis, posterior capsular rent, zonular dialysis, vitreous leak, surgical aphakia, Descemet membrane detachment, placement of ACIOL, Nucleus drop and IOL drop. The patient’s immediate postoperative vision was also noted. SPSS version 15.0.Tunnel related complications were found in 13.98% patients either as scleral button holing or premature entry. Posterior capsular rents and bag disinsertion were found in total of 11.94% patients owing to which 3.07% were left aphakic. 63.13% patients had visual acuity better than 6/12 by snellens chart on first postoperative day. Performance of adequate anterior capsulotomy, minimal handling of the cornea and avoidance of posterior capsular rent are some of the challenges faced by the residents while learning MSICS. Stepwise supervised training can help a resident doctor master these steps while keeping the complications at acceptably low levels. Stepwise supervised training of residents performing MSICS can minimize complications

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