[Conservative management of posttraumatic diplopia]. / Leczenie zachowawcze dwojenia u pacjentów po urazach glowy.

PURPOSE: To determine the effect of prism correction with physicotherapeutic procedures on symptomatic improvement in posttraumatic oculomotor, trochlear and abducent nerves palsy. PATIENTS AND METHODS: Twenty eight patients (five women and twenty three men) at the age range from 23 to 50 years (mean age of 36.5 y.o.) with the posttraumatic ophthalmic complications underwent routine ophthalmic and strabologic examination. Prism correction and vitaminum B1 in iontophoresis were used due to unilateral oculomotor, trochlear and abducent nerve palsy, at 3-11 (mean interval between the trauma and treatment commencement of 7 months) months after traffic accident. Additionally, oculomotor muscles motility training and orthoptic exercises were applied. The duration of therapy ranged from 11 to 18 months (mean treatment duration of 14.5 months). RESULTS: All patients were considered cured at the end of treatment. We achieved the increased ocular range of motion (100%), the reduced horizontal and vertical deviation angle (75%), the extension of palpebral fissure (100%) and regression of diplopia (100%). The binocular vision in the free- and instrument-space environment evaluation improved after treatment (100% simultaneous perception, 100% fusion, 96,43% stereopsis) in 75% and 25% of patients without and with prism correction, respectively. CONCLUSIONS: The use of prism correction led to regression of diplopia, ortophoria without compensatory head position and improved binocular vision function. Prism correction and physicotherapeutic procedures resulted in early improvement of ocular range of motion and accommodation.

[Glaucoma after laser diode treatment in retinopathy of prematurity--case series]. / Jaskra po leczeniu laserem diodowym w przebiegu retinopatii wczesniaczej -opis przypadków.

UNLABELLED: The aim of this study was to analyze treatment and outcomes in children with glaucoma secondary to diode laser photocoagulation in retinopathy of prematurity. METHODS: The group of 1507 newborns, examined as outpatients between 2008 and 2013, were retrospectively analyzed. Five patients (0.3%) (nine eyes) with glaucoma following laser treatment for retinopathy of prematurity were identified. Demographic and clinical data was obtained from medical records and compared with corresponding results in the group of glaucoma-free children subjected to diode laser photocoagulation for retinopathy of prematurity. The statistical analysis included Shapiro-Wilk test and U-Mann-Whitney test with statistical significance level p < 0.05. RESULTS: The following data was collected - mean post-menstrual age at the moment of photocoagulationwas 42 Hbd (38-42) and it was 49.9 (43-54) weeks at the moment of diagnosis of angle-closure glaucoma. The intraocular pressure was significantly elevated in nine in ten eyes which was confirmed objectively and the mean intraocular pressure was 32.0 mmHg (21.6-42.4). The mean corneal diameter was 11.25 mm (10-13) and it was associated with the decreased corneal thickness in pachymetry (p < 0.05). Six eyes (66.6%) required surgical intervention and intraocular pressure normalization was achieved in all patients. Additionally, the affected eyes tended to be myopic (mean spherical equivalent -1.625 diopter) and have a greater axial length (p < 0.05). CONCLUSIONS: Secondary glaucoma can develop following laser treatment for severe retinopathy of prematurity. Topical treatment and surgical intervention provide effective management.

[Plexiform neurofibroma of the upper eyelid and orbit in a patient with von Recklinghausen's disease--case report]. / Nerwiakowlókniak splotowaty powieki górnej i oczodolu w przebiegu choroby von Recklinghausena--opis pacjenta.

Neurofibromatosis type 1 is an autosomal dominant genetic disease, which belongs to the neuro-oculo-cutaneous syndromes (phakomatoses). The authors present a case of a girl with familial neurofibromatosis. In addition to typical skin lesions and Lisch nodules on the iris, the plexiform neurofibroma of the upper eyelid and orbit as well as hamartoma of the central nervous system were observed. Due to the massive infiltration of the left upper eyelid causing its complete ptosis and, in turn, the amblyopia of the left eye, the tumour was partially rexcised. This lesion is not totally removable in most cases due to the early development of neurofibroma during the fetal period and its strong adhesion to the healthy tissues. A massive eyelid infiltration causing amblyopia and dissociation of binocular vision is an indication for early surgery.

Congenital optic disc cyst concomitant with persistent hyaloid artery--a case report.

The aim is to present a rare case of solitary malformation in the form of a congenital optic disc cyst concomitant with the persistent hyaloid artery. The intrabulbar congenital cyst of the optic disc partially covering the medial part of the disc was found in a 3-month old infant. B-San ultrasound confirmed the presence of the intrabulbar heterogeneous mass (7.0 x 2.5 x 5.4 mm) within the vitreous cavity and the concomitant persistent hyaloid artery was shown in Colour Doppler Imaging. The axial length of the involved eye was shorter than of the healthy one (16.68 mm vs. 18.42 mm). The magnetic resonance imaging of the head and orbits performed in the fast spin echo, spin echo and gradient echo sequences in T1 and T2-weighted scans revealed the intrabulbar cyst (7.0 x 2.5 x 6.4 mm), with sharp margins, whose lower part showed intense contrast enhancement. The pericerebral fluid spaces within the frontal and temporal lobes were dilated. Intrauterine toxoplasmosis, cytomegaly, protozoan and helminth infections as well as metabolic diseases were excluded. Patient leukocyte DNA RB1 gene sequencing and negative results of mutation searching excluded retinoblastoma. In a 2-year follow-up period, regression of the mass with the absence of ophthalmic complications was noted. An important reason for the authors to present the discussed case is possible permanent impairment of visual function in patients with similar presentation of congenital peripapillary lesions. congenital optic disc cyst, developmental anomalies of the optic disc, congenital ocular malformations.

The use of galantamine in the treatment of post-traumatic oculomotor and trochlear nerve palsy.

PURPOSE: To assess the suitability of galantamine for the symptomatic treatment of post-traumatic oculomotor (III) and trochlear (IV) nerve palsy. MATERIAL AND METHODS: The routine ophthalmic and strabological examination was performed in five patients (4 females and 1 male) at the age of 31 to 57 years (mean 40.7) with the post-traumatic ophthalmic complications. Due to the unilateral oculomotor and trochlear nerve palsy, which had not resolved within 2-6 (mean duration of 4 months) months following traffic accident, galantamine was used. Nivalin and Reminyl were administered in iontophoresis and orally, respectively, for 10-18 months (mean duration of 14 months). The ocular muscle motion exercises and prism correction were also used. RESULTS: The increased range of ocular motion (100%), reducing of the angle of strabismus horizontally (40%) and vertically (60%), statistically significant extension of palpebral fissure (60%), and regression of diplopia (80% total without correction) were observed. The binocular vision after treatment in the free- and instrument-space environment were also improved (100% simultaneous perception, fusion 80%, stereopsis 60%). CONCLUSIONS: The early galantamine administration in patient with n. III and n. IV post-traumatic palsy accelerates the resolution of post-traumatic ophthalmic symptoms. It is an effective treatment which offers the elimination of strabismus, diplopia and ptosis, at the same time improvings ocular movements and binocular vision. galantamine, post-traumatic nerve palsy, oculomotor and trochlear nerves.

[Correction of refractive errors in patients with strabismus. Part I. Clinical problems associated with refraction, accommodation and convergence]. / Korygowanie wad refrakcji u pacjentów z choroba zezowa. Czesc. Kliniczne problemy zwiazane z refrakcja, akomodacja i konwergencja.

In Part I the problems associated with refraction, accommodation and convergence and their role in proper eye position/visual alignment of the eyes as well as convergent, divergent and vertical alignment of the eyes have been described.

[Correction of refractive errors in patients with strabismus. Part II. Clinical aspects of refraction--spectacle and contact lens correction]. / Korygowanie wad refrakcji u pacjentów z choroba zezowa. Czesc II. Kliniczne zagadnienia refrakcji--korekcja soczewkami okularowymi i kontaktowymi.

In Part II the clinical aspects of refractive errors such as hyperopia, myopia, astigmatism, anisometropia, aphakia and unilateral pseudophakia have been described along with strabismus and prism and spectacle correction allowing additionally proper visual alignment.

[Evaluation of acuity stereopsis in school children and teenagers with developmental dyslexia]. / Zachowanie sie ostrosci widzenia stereoskopowego u dzieci i mlodziezy z dysleksja rozwojowa.

INTRODUCTION: The purpose of this study was to show to what extent developmental dyslexia influences a scope of stereoscopic. MATERIAL AND METHODS: 176 pupils and students with developmental dyslexia were examined, including 52 girls and 124 boys aged between 8 and 19. Subjects were divided into three groups in respect of their age: I group 8-10 years, II group 10-14 years, III group 15-19 years of age, and in respect of a type of dyslexia into: visual and spatial type (W), language and auditory (S) and mixed (M). Long distance visual acuity in both eyes was 1.0 and near sight visual was 0.5 according to Snellen charts after correction of refraction error. Error of refraction ranged from +/- 0.5 Dsph to -2.25 Dsph and +3.0 Dsph, while astigmatism ranged from +/- 0.5 Dcyl to -2.0 Dcyl, +2.25 Dcyl. All the subjects had binocular vision in free space and on synoptophore (simultaneous perception, fusion, stereopsis). Reference group consisted of children and school children without ophthalmological pathological state. While analysing the obtained results it was found that the pupils and students with developmental dyslexia of group I and II and of dyslectic pathogenic groups (W, S, M) reached statistically considerably higher values of stereoscopic vision angle compared with analogous the control group. No significant differences were found between the age groups of pupils and students with dyslexia and dyslectic pathogenic groups and the control group within the scope of stereoscopic vision acuity and perception of Titmus test stereopsis threshold value of 40 arc sec. RESULTS: In dyslectic pathogenic groups (W, S, M) compared with the control group, the perception of Titmus test threshold value of 40 arc sec was observed significantly and statistically, less frequent. CONCLUSIONS: In all pupils and students with developmental dyslexia value of stereopsis angle was statistically considerably higher, while the frequency of stereopsis threshold value perception for Titmus test was observed statistically considerably less often compared with values obtained in control group.