ABSTRACT
The Otago photoscreener is a 35 mm single len reflex camera in which the flash light comes from a narrow ring around the outer margin of its lens. The margin is also the limiting aperture of the optic system and in the centre of the lens is a flickering fixation light. In a colour photograph taken at a distance of 66 cm from the face of the subject who is accurately focusing on and fixing the camera fixation light with both eyes, the fundus reflex in each pupil is very dark red and the corneal light reflexes are symmetrical. If either or both eyes are not appropriately focused or fixing, the fundus reflex is brighter and yellow or white. This article describes a prospective trial of the performance of the Otago photoscreener in a series of 1000 infants with actual or suspected amblyopia, refractive error or strabismus. In this study photoscreening showed a sensitivity of 94% and a specificity of 79%. Photoscreening also identified some cases of esotropia and of refractive error which were missed on clinical examination. In this series photoscreening passed as normal three children with mild to moderately severe amblyopia. This represents les than 1% of the clinically abnormal children.
Subject(s)
Amblyopia/diagnosis , Ophthalmology/methods , Photography/instrumentation , Strabismus/diagnosis , Child , Child, Preschool , False Positive Reactions , Female , Humans , Infant , Male , Ophthalmology/instrumentation , Prospective Studies , Reproducibility of Results , Sensitivity and Specificity , Visual AcuityABSTRACT
A retrospective study was performed on the results of surgery in infantile esotropia with the aim of comparing recessions with a loop (a procedure in which the effect of a recession is increased by attaching the muscle to the globe with an intervening loop of suture to lengthen the tendon) to standard recession operations. The results of surgery were examined in 188 cases, of which 41 had been treated using a loop alone and 38 using a loop combined with a recession. The loop or sling procedure was found to be as predictable as conventional surgery and effective in increasing the amount of correction obtained.
Subject(s)
Esotropia/surgery , Tendons/surgery , Child , Evaluation Studies as Topic , Humans , Prognosis , Retrospective Studies , Strabismus/surgery , Surgical Procedures, Operative/methodsABSTRACT
A child with Refsum's disease presented with cardiac failure, marked muscle wasting, weakness and inco-ordination. Management with multiple plasma exchanges and dietary restriction of phytanic acid intake has reversed the disabling features of the disease, although levels still remain higher than target values. Low phytanic acid intake is being achieved by restriction of total fat to 10 to 12 g/day, while allowing free amounts of fruit and green vegetables.
Subject(s)
Phytic Acid/administration & dosage , Plasma Exchange , Refsum Disease/therapy , Child , Combined Modality Therapy , Follow-Up Studies , Humans , Male , Neurologic Examination , Phytic Acid/blood , Refsum Disease/blood , Refsum Disease/diet therapyABSTRACT
A surgical procedure is described for the correction of cicatricial ectropion secondary to actinic skin damage. This involves the rotation of an upper lid skin and muscle flap to the lower lid, thereby reversing the cicatrising process. The procedure, its advantages and disadvantages, are outlined. The procedure was successful in 44 of the 48 lids reviewed.
Subject(s)
Cicatrix/surgery , Ectropion/surgery , Eyelids/surgery , Surgical Flaps , Humans , MethodsABSTRACT
Thirty-three patients with ocular birdshot injuries are reviewed. Four of these patients had bilateral trauma. The visual prognosis was poor; 26 eyes (70.3%) became blind. The best vision was retained in eyes where the pellet had ricocheted off the globe causing contusion damage only. Once the eyeball was penetrated prognosis worsened considerably.
Subject(s)
Eye Injuries/etiology , Visual Acuity , Wounds, Gunshot/complications , Adolescent , Adult , Child , Female , Humans , Male , Middle AgedABSTRACT
A total of 34 lids with aberrant lashes were treated with the specifically designed Collin cryoprobe without microthermocouple temperature monitoring. A high success rate of 82% was obtained. By applying the cryoprobe to the lid margin and conjunctival surface instead of to the skin it was possible to limit the degree of depigmentation in these highly pigmented lids, and only one patient showed a mild cosmetic blemish. The treatment was repeated on up to three occasions without an increase in complications.
