ABSTRACT
PURPOSE: To study the effects that the abnormal eye movements of patients with Duane retraction syndrome have on the development of binocular function. METHODS: Pattern reversal visual evoked responses (VEPs) to 15-minutes-of-arc and 60-minutes-of-arc checks and binocular beat VEPs to diffuse sinusoidally modulated 18- and 20-Hz stimuli were recorded in 10 patients with Duane retraction syndrome who maintain binocular function by using an abnormal head posture. Visual acuity, stereoacuity, and eye movements were measured. The results have been compared to those from 10 normal subjects. RESULTS: The patients with Duane retraction syndrome had reduced stereoacuity compared to the normal control group (TNO mean, 82.5 seconds of arc compared to 37.5 seconds of arc; Titmus mean, 143 seconds of arc compared to 44 seconds of arc). The binocular beat VEPs showed a significantly reduced difference beat response at 2 Hz in the patients with Duane syndrome compared to normal subjects (mean signal-to-noise ratio 2.40 +/- 1.05 compared to 4.30 +/- 2.66; t = 2.21, df = 18, P < 0.05). Binocular enhancement of the P100 pattern reversal amplitude to 15-minute checks was increased in these patients, because of a reduction of the monocular P100 amplitudes compared to the normal group. CONCLUSIONS: Patients with Duane syndrome who maintain binocular function using an abnormal head posture have reduced stereoacuity and show electrophysiological evidence of reduced cortical binocular interaction.
Subject(s)
Duane Retraction Syndrome/physiopathology , Evoked Potentials, Visual/physiology , Vision, Binocular/physiology , Visual Acuity/physiology , Adolescent , Adult , Child , Eye Movements/physiology , Female , Humans , MaleABSTRACT
PURPOSE: To study 13 eyes with less than -4.0 to -7.0 diopters of myopia that developed central or inferior keratectasia after laser in situ keratomileusis (LASIK). METHODS: The progress of the ectasia was determined by a series of pre- and post-LASIK topographies and the case histories. RESULTS: Progressive ectasia developed from 1 week to 27 months after LASIK. This necessitated the wearing of hard contact lenses or penetrating keratoplasty. One eye improved for some months after photorefractive keratectomy retreatment. Two eyes in 1 patient and 1 eye in a second patient had latent keratoconus before surgery. CONCLUSION: Laser in situ keratomileusis can cause permanent weakening and ectasia of the cornea even in eyes with low myopia.
Subject(s)
Cornea/pathology , Corneal Diseases/etiology , Iatrogenic Disease , Keratomileusis, Laser In Situ/adverse effects , Myopia/surgery , Refraction, Ocular , Adult , Contact Lenses , Cornea/surgery , Corneal Diseases/pathology , Corneal Diseases/therapy , Corneal Topography , Dilatation, Pathologic/etiology , Dilatation, Pathologic/pathology , Dilatation, Pathologic/therapy , Disease Progression , Female , Humans , Keratoplasty, Penetrating , Male , Middle Aged , Reoperation , Visual AcuityABSTRACT
A method of combined cataract extraction and trabeculectomy using phacoemulsification through a modified 5 mm sutureless scleral tunnel incision is described. In eight patients who were followed for a minimum of five months in an initial series, the intraocular pressure (IOP) decreased to less than 19 mm Hg; six achieved this result at six months on no medication. The IOP decreased from a mean of 30.88 mm Hg preoperatively to 13.75 mm Hg at two months and 14.00 mm Hg at six months. The preoperative mean of 3.63 antiglaucoma medications per patient decreased to 0.25 postoperatively. Although all patients had advanced glaucomatous optic neuropathy with a preoperative mean cup/disc ratio of 0.79, visual acuity improved in six patients; four patients had an acuity of 20/40 or better at both one week and two months. Surgically induced astigmatism averaged 0.57 diopter (D) at two months, with a mean astigmatic shift of 0.08 D with the rule at two months and 0.41 D with the rule at three months. No hypotonous or flat anterior chambers were encountered; there were visible blebs in seven patients at six months. The sutureless phacotrabeculectomy preserves all the advantages of small incision phacoemulsification and appears to be a safe and effective combined procedure for IOP control in glaucoma patients with cataracts.
Subject(s)
Cataract Extraction/methods , Sclera/surgery , Surgical Flaps/methods , Suture Techniques , Trabeculectomy/methods , Aged , Aged, 80 and over , Astigmatism/etiology , Female , Follow-Up Studies , Glaucoma, Angle-Closure/surgery , Glaucoma, Open-Angle/surgery , Humans , Intraocular Pressure , Lenses, Intraocular , Male , Postoperative Complications , Visual AcuityABSTRACT
PURPOSE/METHODS: In a patient with a coloboma of the optic nerve, inferior retina and choroid, and deep portions of the sclera, a retrobulbar vessel moved irregularly relative to the retinal vessels, which moved contiguously with the posterior globe. RESULTS/CONCLUSION: Fluorescein angiography showed the retrobulbar vessel filling slightly later than overlying retinal vessels. We conclude that the retrobulbar vessel was a vein situated inferiorly to the optic nerve.
Subject(s)
Choroid/abnormalities , Coloboma/physiopathology , Eye/blood supply , Optic Nerve/abnormalities , Retina/abnormalities , Adult , Fluorescein Angiography , Fundus Oculi , Humans , Male , Ophthalmoscopy , Regional Blood Flow/physiology , Retinal Vein/physiology , Veins/physiologyABSTRACT
All patients admitted to one firm of the Department of Medicine were psychiatrically evaluated in terms of Diagnostic and Statistical Manual of Mental Disorders (DSM III, 1980) criteria. Thirty-three per cent of the patients had treatable psychiatric disorders while only 3.5% of admissions to a comparable firm of the same department were referred for psychiatric consultation (P < 0.05). These data support the need for a more comprehensive liaison psychiatric service than a mere consultation service in the general hospital.
