ABSTRACT
BACKGROUND: The diagnostics and therapy of optic neuritis are complex and require interdisciplinary cooperation. AIM: Compact, up-to-date recommendations for the clinician appear to be desirable. MATERIAL AND METHODS: A selective literature search including the authors' professional experience was carried out. An algorithm for the practical approach to optic neuritis was derived from the best available evidence. RESULTS: Our recommendation distinguishes between compulsory and optional investigations. Differential diagnostic cues with regard to atypical optic neuritis and other optic neuropathies are shown. Standard therapy patterns and means of escalation are suggested. Indications for referral are presented. CONCLUSION: The algorithm suggested in this article provides ophthalmologists with an effective orientation aid for the complete treatment procedure of optic neuritis.
Subject(s)
Multiple Sclerosis/diagnosis , Multiple Sclerosis/therapy , Neurology/standards , Ophthalmology/standards , Optic Neuritis/diagnosis , Optic Neuritis/therapy , Practice Guidelines as Topic , Humans , Multiple Sclerosis/complications , Optic Neuritis/etiologyABSTRACT
Disorders of ocular motility due to multiple sclerosis can cause significant symptoms, such as blurred vision, diplopia, oscillopsia and dizziness. The spectrum of ocular motor disorders is broad due to the multifocal nature of the disease. The most frequent disorders include dysmetric saccades, impaired smooth pursuit, internuclear ophthalmoplegia (INO), impaired vestibulo-ocular reflex, misalignment of visual axes, impaired vergence and gaze-evoked nystagmus. Patients with abnormal eye movements are more handicapped than patients without ocular motility disorders as eye movement disorders and gait disturbances are both caused by an extensive involvement of the brainstem and cerebellum.
Subject(s)
Multiple Sclerosis/diagnosis , Multiple Sclerosis/therapy , Ocular Motility Disorders/diagnosis , Ocular Motility Disorders/therapy , Humans , Multiple Sclerosis/complications , Ocular Motility Disorders/etiologyABSTRACT
Early diagnosis of Graves' orbitopathy (GO) is important for a timely treatment of the disease. The diagnosis is based on clinical as well as radiological findings. Detailed assessment and follow-up mainly rely on standardized clinical examinations which register symptoms and signs including inflammation, upper lid retraction, exophthalmos, eye muscle involvement and diplopia, corneal involvement, raised intraocular pressure and optic nerve involvement, the latter representing a particular challenge. Each case of GO is classified in terms of severity and activity allowing suitable therapeutic strategies to be derived.
Subject(s)
Diagnostic Imaging/methods , Diagnostic Techniques, Neurological , Graves Ophthalmopathy/diagnosis , Diagnostic Techniques, Ophthalmological , HumansABSTRACT
BACKGROUND: Vision-related quality of life is an important endpoint for evaluation studies and quality assurance projects. The objective of this study is to conduct a psychometric test of the German version of the "Children's Visual Function Questionnaire" (FKS) in the version for children over age 3. METHODS: In a sample of n=236 children with various eye diseases distribution properties, internal consistency, unidimensionality, validity, and the fit of the FKS data to the Rasch model are tested. In addition, reference values are given for users. RESULTS: The FKS has satisfactory internal consistency and is valid in the sense that expected significant correlations occur with visual acuity. The weakness of the FKS, which provides impulses for further development, is primarily related to the scales for competence and personality in the following three areas: (1) high percentage of inapplicable questions, (2) ceiling effects, and (3) lack of unidimensionality. CONCLUSIONS: Overall, the FKS satisfactorily complies with psychometric standards. Therefore, it can be applied to assess children's vision-related quality of life.
Subject(s)
Eye Diseases/diagnosis , Surveys and Questionnaires , Vision Disorders/diagnosis , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Male , Psychometrics/statistics & numerical data , Quality of Life , Reproducibility of Results , Vision Disorders/epidemiology , Vision ScreeningABSTRACT
Nystagmus can be associated with strong discomfort due to oscillopsia, blurry vision and dizziness. Since generally no curative treatment methods exist, studies focus on potential pharmaceuticals to dampen the nystagmus. An overview is given on which forms of nystagmus can be treated with what kind of pharmacological substances and their possible mechanism of nystagmus dampening. Controlled studies found gabapentin and memantine to be effective in acquired pendular nystagmus and early-onset idiopathic nystagmus, and an efficacy of 4-aminopyridine in downbeat nystagmus.
