Subject(s)
Fundus Oculi , Retina/pathology , Retinoschisis/pathology , Child , Eye Proteins/genetics , Humans , Male , Mutation , Phenotype , Retinoschisis/genetics , Visual AcuityABSTRACT
A retrospective review was carried out of patients under 16 years old with malignant hypertension, who had been referred to a teaching hospital ophthalmology department because of reduced visual acuity. Four patients (three girls, one boy) were seen between 1994 and 2000 with a mean age at presentation of 11.5 years (range 9-15). In the short term, visual acuity improved after control of blood pressure in all four patients. However, in the long term, two patients were registered blind one to two years after presentation, one because of a choroidal neovascular membrane developing at the macula, and the other because of progressive optic neuropathy. Both of these patients had a longer duration of symptoms before diagnosis, worse visual acuity, and higher blood pressure at presentation when compared with the patients who made a good visual recovery. These observations suggest that early diagnosis of malignant hypertension in children is essential in reducing the likelihood of permanent severe visual damage.
Subject(s)
Blindness/etiology , Hypertension, Malignant/complications , Adolescent , Child , Choroidal Neovascularization/etiology , Female , Fluorescein Angiography , Follow-Up Studies , Fundus Oculi , Humans , Hypertension, Malignant/physiopathology , Male , Optic Nerve Diseases/etiology , Prognosis , Retrospective Studies , Visual AcuityABSTRACT
The ocular surface is altered in kerato-conjunctivitis sicca, a disorder of aqueous tear production. Many of the factors leading to these surface changes are now more clearly understood and are discussed in this paper.
Subject(s)
Cornea/physiopathology , Keratoconjunctivitis Sicca/physiopathology , Keratoconjunctivitis/physiopathology , Conjunctiva/pathology , Humans , Leukocyte Count , Mucins/analysis , Osmolar Concentration , Surface Tension , Tears/analysis , Tears/physiology , ViscosityABSTRACT
A 16-year-old girl presented with contact lens intolerance. She was found to have a marked deficiency of meibomian glands in the upper lids and almost total absence in the lower lids. Evidence of tear film instability was found and attributed to deficient lid oil production. A daily wear soft contact lens was later fitted and tolerated.
Subject(s)
Eyelid Diseases/congenital , Eyelids/abnormalities , Meibomian Glands/abnormalities , Adolescent , Contact Lenses, Hydrophilic , Eyelid Diseases/pathology , Eyelids/pathology , Female , Humans , Meibomian Glands/pathologyABSTRACT
Constituent long-chain fatty acids and alcohols from the meibomian secretions of the rat were examined as trimethylsilyl (TMS) and methyl ester-TMS derivatives by capillary gas chromatography and by combined gas chromatography-mass spectrometry. The positions of double bonds and methyl branch points were determined by the mass spectra of picolinyl esters and nicotinates for long-chain fatty acids and alcohols, respectively. Fatty acids had chain lengths from C12 to C34 and were of the straight-chain iso, anteiso and monounsaturated types. The unsaturated acids had double bonds in the omega-7 and omega-9 positions. The alcohols had corresponding structures. In common with the constituent acids and alcohols of other meibomian secretions, the chain lengths of the constituents showed a biphasic distribution with maxima around C16-C18 and C25-C27. The profile was qualitatively similar to that obtained from human meibomian secretion but with some differences in the relative proportions of certain acids and alcohols.
Subject(s)
Eyelids/analysis , Fatty Acids/analysis , Fatty Alcohols/analysis , Meibomian Glands/analysis , Animals , Gas Chromatography-Mass Spectrometry , Humans , Male , Rats , Rats, Inbred Strains , Sterols/analysisABSTRACT
The accuracy of a diagnostic technique; non-invasive tear film break-up time (NIBUT) was determined by calculating the sensitivity and specificity of the test. Thirty-three dry eye patients (65 eyes) of varying severity (mild, moderate and severe) and 66 age and sex matched normal subjects (132 eyes) were examined. The results indicate that the critical value of 10 seconds for the NIBUT provides sensitivity of 82% and specificity of 86%.
Subject(s)
Keratoconjunctivitis Sicca/diagnosis , Keratoconjunctivitis/diagnosis , Tears , Adult , Aged , Blinking , Female , Humans , Male , Methods , Middle Aged , Time FactorsABSTRACT
We evaluated the effect of 0.1% sodium hyaluronate (unpreserved) in 10 patients with dry eyes. The precorneal tear film break-up time was assessed by the non-invasive technique, and the severity of symptoms was recorded before and after treatment on a 0 to +3 scale. It was found that the tear film stability was significantly increased (p less than 0.05) in eyes treated with sodium hyaluronate. The symptoms of grittiness and burning were also significantly alleviated in the treated eyes.
Subject(s)
Hyaluronic Acid/therapeutic use , Xerophthalmia/drug therapy , Adult , Aged , Female , Humans , Male , Middle Aged , Tears/drug effects , Tears/physiology , Time FactorsABSTRACT
The effect of unpreserved topical anaesthetic on tear film stability (0.4% oxybuprocaine hydrochloride) was investigated in a double masked randomised study in 12 healthy volunteers, using a noninvasive tear film break up technique (NIBUT). It was found that the topical anaesthetic did not reduce the pre-corneal tear film stability, contrary to the electron microscopic evidence.
Subject(s)
Anesthetics, Local/pharmacology , Procaine/analogs & derivatives , Tears/drug effects , Adult , Cornea/drug effects , Female , Humans , Male , Ophthalmic Solutions , Procaine/pharmacology , Random Allocation , Sodium Chloride/pharmacologyABSTRACT
The detrimental effect of meibomian oils expressed onto the lid margins on the value of the Schirmer test was investigated in two studies (N = 12 per study): without and with topical anaesthesia. In the 12 subjects studied there was no evidence of external ocular disease. The studies were conducted in a double masked randomised cross-over fashion. It was found that neither expression of meibomian oils nor topical anaesthesia showed any statistically significant (P greater than 0.05) reduction in final tear secretion rates. Thus, the notions that lid manipulation may impede tear flow into the Schirmer strip and that topical anaesthesia reduces apparent tear flow, are not supported.
Subject(s)
Eyelids/physiopathology , Meibomian Glands/physiopathology , Oils/physiology , Tears/metabolism , Xerophthalmia/diagnosis , Adult , Anesthetics, Local/pharmacology , Diagnostic Errors , Double-Blind Method , Female , Humans , Male , Middle Aged , Procaine/analogs & derivatives , Procaine/pharmacology , Random Allocation , Reagent StripsSubject(s)
Conjunctiva/ultrastructure , Conjunctivitis/pathology , Animals , Arachidonic Acids/toxicity , Cell Count , Conjunctiva/blood supply , Conjunctiva/immunology , Conjunctivitis/chemically induced , Desmosomes/ultrastructure , Epithelium/ultrastructure , Fluorescein Angiography , Histamine Release , Humans , Langerhans Cells/ultrastructure , Leukocyte Count , Microscopy, Electron , Pigmentation , Rabbits , Rats , Tears/immunologyABSTRACT
A computer program in BASIC has been written which will compute all scores for the Farnsworth 100-hue test, and plot them in the appropriate colour on a polar co-ordinate graph. Hard copy can be obtained on a dot-matrix printer. The program is simple to use, and considerably curtails the analysis time for this test, as well as eliminating possible computational errors.
Subject(s)
Color Perception Tests/methods , Computers , Software , HumansABSTRACT
A simple, non-invasive technique has been developed for assessment of the stability of the pre-corneal tear film. Changes are observed in the reflection of a grid pattern from the tear film surface. Breaks in the tear film appear as random discontinuities in the grid image. Using this non-invasive technique the stability of the pre-corneal tear film was assessed in nine normal subjects and twelve established dry-eye patients. The non-invasive tear film break-up time (NIBUT) of the dry-eye patients was on average only 25% to 32% of normal values. The non-invasive technique provides an alternative approach to diagnosing non-wetting disorders as well as a means of evaluating the efficacy of artificial tear solutions.
Subject(s)
Ophthalmology/instrumentation , Tears/physiology , Xerophthalmia/diagnosis , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Time FactorsABSTRACT
Non-invasive tear film break-up time (NIBUT) was measured in nine normal subjects to investigate the effect of fluorescein instillation of tear film stability. It was found that fluorescein instillation reduced the tear film stability in the treated group, compared with the control group (P less than 0.05). It is, therefore likely that the tear film stability may be greater than had hitherto been suggested by the fluorescein method.
