Sagittal distal limb kinematics inside the hoof capsule captured using high-speed fluoroscopy in walking and trotting horses.

Kinematic evaluation of the distal limb of the horse using standard methods is challenging, mainly due to the hoof capsule restricting visualisation, but the recent development of a high-speed fluoroscopy (HSF) system has allowed in vivo cineradiographic assessment of moving skeletal structures at high speeds. The application of this non-invasive method to the equine distal limb is used to describe 'internal' distal limb kinematics including intra-horse and inter-horse variability, and variability between walk and trot. Distal limb kinematic data were collected at walk and trot from six non-lame horses using HSF set over a force plate. The dorsal proximal interphalangeal joint (PIPJ) angle and the dorsal distal interphalangeal joint (DIPJ) angle were measured at toe-on and at 25%, 50% and 75% of stance. The PIPJ and DIPJ showed overall extension through stance. The mean ± SD range of motion (ROM) during stance of the PIPJ was 9.7 ± 2.7° (walk) and 8.7 ± 3.0° (trot) and of the DIPJ was 28.6 ± 4.6° (walk) and 26.5 ± 6.3° (trot) showing significant differences between gaits and changes through stance (P < 0.001). Inter- and intra- horse variations were also significant for both joint angles (P < 0.001). HSF allowed for kinematic assessment of the distal limb within the hoof capsule. The ROM of the PIPJ observed was similar to results published in the literature whilst the ROM for the DIPJ was less than values previously reported. Future studies will use HSF to estimate strain in the tendons and ligaments within the hoof capsule, which are a common site of lameness in the horse.

Bilateral third and unilateral sixth nerve palsies as early presenting signs of metastatic prostatic carcinoma.

PURPOSE: To report four cases of cranial nerve palsy, which presented to the ophthalmologist as the only or one of the earliest manifestations of prostatic carcinoma. This is an infrequent complication of metastatic prostatic carcinoma usually only occurring late in the disease process in those with a history of prostatic carcinoma. METHODS: The case records of four patients with a history of a cranial nerve palsy who attended the ophthalmology department and who had a recent or subsequent diagnosis of prostatic carcinoma were reviewed. RESULTS: Diplopia caused by lesions affecting the third and sixth nerves sometimes in association with sensory symptoms may be a manifestation of metastatic prostatic carcinoma. These findings are consistent with base of the skull metastases from the condition. Two patients are still alive 54 months and 12 months after the diagnosis. One of the patients died 13 months after the diagnosis of prostatic carcinoma was made and the other died 21 months after the diagnosis from an unrelated hypertensive brain haemorrhage. CONCLUSIONS: Any patient presenting with diplopia must have an adequate past medical history taken and in an elderly gentleman this should include symptoms of prostatic disease. If indicated urological referral and measurement of prostate specific antigen may be performed. In patients whose cranial nerve palsy is complicated by other sensory signs or those in whom no sign of recovery occurs in 2 months, a contrast CT scan asking for bone windows to be included may be helpful in delineating any pathology. Radiotherapy may be useful for the treatment of metastatic prostatic carcinoma causing cranial nerve palsies with some patients experiencing either complete or partial resolution of their symptoms. The effect of newer hormonal agents or chemotherapy on this aspect of the disease is not well documented in current literature.

Controlled study of ocular morbidity in school children born preterm.

Two hundred children who were of very low birth weight (VLBW) (1500 g or less) and 193 controls who were of normal birth weight (NBW) were examined at approximately 9 years of age. Binocular visual acuity of 6/6 or better was noted in 178 (89.5%) VLBW children and 189 (97.9%) NBW children. Visual morbidity was significantly higher among VLBW children. Strabismus was present in 38 (19%), cicatricial retinopathy of prematurity in 13 (6.5%), and optic atrophy in six (3%) children in this group. Children who were VLBW were also more myopic than the NBW controls. Optic atrophy was frequently associated with cerebral dysfunction. Regular assessments to identify ocular abnormalities in children who were VLBW are recommended.

Late presentation of congenital ectropion of the eyelids in a child with Down syndrome: a case report and review of the literature.

Congenital eversion or ectropion of the upper eyelids is rare. Only 50 cases have been reported since the condition was first described in 1896. We encountered an additional case of congenital ectropion of the eyelids, which is also unusual because of its late presentation for treatment. This case demonstrates the unfavorable outcome of failure to treat this condition at birth and illustrates the association with Down syndrome. Our case is compared with the others reported in the literature.

Causes of loss of vision in congenital glaucoma.

Of 51 patients with congenital glaucoma, 13 had unilateral and 38 bilateral disease. Pressure was controlled at 8 to 24 mm Hg in 76 of the 89 affected eyes. Forty-one of these 76 eyes had visual acuity poorer than 6/15 (20/50); optic nerve damage as shown by visual field testing was the cause in 20, and medial opacities, including irregular corneal astigmatism, was the cause in 15. In only six eyes did the poor vision result from anisometropic amblyopia.

Aetiological survey of visually handicapped children in Northern Ireland.

A survey of visually h,ndicapped children in Northern Ireland identified 486 subjects aged 0 to 20 years on January 1, 1976, with a corrected visual acuity of 6/18 or less in the better eye. The prevalence of visual handicap was 81/100,000 of the population with an estimated ascertainment rate of 80%. Genetically determined diseases accounted for 51% of the cases. Birth hypoxia secondary to prenatal and perinatal complications was the second most important aetiological factor contributing towards visual handicap.