Adjustable horizontal rectus muscle recession technique

Twenty patients with pure horizontal deviations were selected to evaluate the efficacy of surgical treatment by using the adjustment recession technique to attain ocular alingment with one operation and to minimize the need for staged operation or reoperation. The patients were operated upon using the two stage technique. The first stage is done under general anaesthesia while the second under local topical aneasthesia when the patient is awoke and cooperative four to six hours post-operatively. Ninty five percent of the cases attained the desirable goal with one procedure. Adjustment technique is specially needed whenever the surgical results are unpredictable. One can and should consider it in almost all adult strabismic cases

role of panretinal photocoagulation in the treatment of proliferative diabetic retinopathy

In the present study, 50 eyes of 34 diabetic patients presenting with optic disc neovascularization were subjected to panretinal argon laser photocoagulation. The condition of the disc new vessels [NVD] and fibrous proliferation of the disc was graded before and after treatment, according to one to four severity rating. The factors which could affect the response of the eyes to treatment either ocular systemic were studied the follow up period ranged between 6 and 18 months

Macular changes in diabetic retinopathy

Twenty diabetic patients showing diabetic retinopathy were examined to study the various maculopathies is different stages of diabetic retinopathy. Detailed examination for every patient was one, including fundus examination. Slit lamp biomicroscopy, colour vision testing, central field testing by Goldmann perimeter and Amsler grid test. Fluorescein angiography was done for every patient to evaluate the stage of diabetic retinopathy with special attention to the macular condition Diabetic maculopathy was classified into-retinal and pre-retinal maculopathies. It was found that advanced stages of diabetic maculopathy were not necessarily associated with advanced stages of diabetic retinopathy

Management of senile cataract in diabetic patients

The association between cataract and diabetes has been the subject of much controversy. The treatment of cataract in diabetics is essentially surgical as in non-diabetics. Prior to the operation a good control of the metabolic state is required to lessen the complications. This can be achieved either by oral hypoglycasmics or insulin. No statistical differences were found in operative and post-operative complications among diabetics and non-diabetics except vitreous haemorrhage which occurred solely in the former group. I.C.C.E. operation was found to have a detrimental effect on the retinopathy, this progressed post-operatively in an aggressive manner. The net visual outcome was worse among diabetics with retinopathy especially the proloferative type. Insulin-dependent diabetics were found to have the worse prognosis regarding vision, evolution of retinopathy and complications

enucleation operation and its indications

During five years [1975 - 1979], 137 enucleations [2.63%] out of 5209 operations were done. The most common causes of enucleation in this series were trauma in 55 cases [40.14%], followed by staphyloma [17.52%], absolute glaucoma [15.33%], malignant tumours [13.14%] and endophthalmitis [8.03%]

Significance of electro-retinogram and ultrasonography in management of complicated Cataract

There are many difficulties to evaluate the retinal function in complicated cataract, but electro-retinogram [ERG] and ultrasonography may help in the diagnosis. The ERG evaluation helps in localization of possible damage and appreciation of the diagnostic changes in the retina of photopic and scotopic recovery. [Ballantyne 1972].The ERG may give a useful information in clinical conditions as occlusion of central retinal artery, retinal detachment and abiotrophies where the response is subnormal or extinguished, where as in chorio-retinitis and high myopia it is subnormal.[Arden 1962 and Moses 1970]. The second tool applied is ultrasonography. The first investigators to apply it in ophthalmology were Mundt and Hughes [1958] in Chicago and Oksala and Lehtinen [1957] in Finland. Its value has now been shown to be considerable [Oksala and Lehtinen 1960, Baum and Greenwood 1969, Alagine 1971, Coleman et al 1977 and Wainstock 1979]. The main advantages lie in analysis of the contents of the posterior segment of the globe where visual exploration is impossible owing to opacities in the lens or vitreous haemorrhage, opacities or masses of fibrous tissue. Retinal detachment or radio-transparent foreign body can be detected [Coleman et al 1977]. The aim of the work is to evaluate the use of ERG and ultrasonography in the management of complicated cataract to detect the underlying cause. All cases of cataract [433 cases] admitted to the ophthalmic department of the main hospital of Health Insurance of Alexandria in a period of one year and half [1980 and first half of 1981]. Two hundred and forty-five cases [56.6%] of them were complicated. One hundred and fifty-six of these complicated cases [63.7%] were operated upon. The rest were discharged out because they were not fit for surgical interference. Full ophthalmic examination of patients was carried out including visual acuity, projection of light, measuring of IOP [by both applanation and Schiotz tonometers], slit-lamp examination. Detection of any error of refraction and fundus examination of the other eye were done if cataract was not present. Estimation of the fasting blood sugar level was also carried out. Ultrasonography and/or ERG were carried out in cases suspected to have posterior segment lesion [48 patients]. Intra-capsular cataract extraction was performed in 8 cases, out of those 48 cases where bad prognosis was suspected by ERG and ultrasonography. Post operative complications were observed. Visual acuity was measured after operation. ERG alone was done for 11 cases and ERG with ultrasonography were carried out for 37 patients