Normal S-cholesterol indicates unchanged S-LDL, S-HDL and S-triglycerides in patients with previously acceptable blood lipids.

BACKGROUND: Analysis of blood lipids should be repeated routinely in many patients, and limiting testing to total cholesterol may eliminate the need for fasting prior to sampling, thereby saving time and money. The primary aim was to investigate the sufficiency of S-cholesterol analysis (TC) in monitoring all blood lipids. MATERIAL AND METHODS: The results of blood lipid measurement in blood samples taken at a primary care unit over a 10-year period were studied retrospectively, and the probability of TC predicting acceptable levels of LDL, HDL and TG was calculated. RESULTS: Blood lipid levels from two samples in 518 patients taken within an interval of 0.5 to 3 years were accessible for study. If TC, LDL, HDL and TG levels were previously acceptable within this interval, a single acceptable TC was a predictor of acceptable LDL (97 %), HDL (94-97 %) and TG levels (96 %). CONCLUSIONS: In patients requiring blood lipid monitoring, it may be concluded that if TC, LDL, HDL and TG levels are acceptable in one blood sample, this is sufficient to monitor TC levels. If TC levels remain acceptable, there is no need to analyse LDL, HDL and TG levels more than every second year.

Role of optometric vision therapy for surgically treated strabismus patients.

BACKGROUND: Occasionally, co-management involving both optometry and ophthalmology is needed to optimize treatment outcome for the strabismic patient. METHODS: JB, a 47-month-old consecutive esotrope presented to our clinic. Two previous attempts to surgically correct her exotropia had failed and the parents sought another treatment approach. We recommended optometric vision therapy (VT) to improve sensorimotor fusion before any further surgery. After 31 VT sessions (bi-weekly for a time, then weekly), before a third scheduled surgery, sensorimotor fusion was good in the amblyoscope, but unstable with neutralizing prism in free-space. We recommended surgery be postponed, but the family proceeded. Esotropia recurred with constant suppression. After additional VT, JB developed stable sensorimotor fusion and random dot stereopsis in free-space with neutralizing prism. A fourth surgery was then performed resulting in esophoria at all distances with good sensory fusion. RESULTS: Twenty-one months postoperatively, JB remains nonstrabismic with good sensory fusion. CONCLUSIONS: Clinicians should understand the roles and limitations of available treatment options. Surgery reduces the magnitude of the deviation, whereas optometric VT provides the unique role of establishing normal sensory processing.