Ophthalmology Research Articles

The Evaluation and Management of the Patient with Ptosis

(1989). The Evaluation and Management of the Patient with Ptosis. Seminars in Ophthalmology: Vol. 4, No. 3, pp. 111-126.

Team approach to home health care delivery: optometry as the primary vision care provider.

The purpose of this report is to describe a vision care program, utilizing optometry as the primary vision care provider, for patients unable to obtain care in traditional ways. The impact of this program upon the community, its impact upon an educational curriculum, and the program itself are discussed. The program provides a model for delivery of health care to patients who would otherwise go without care.

Optometric Care for the Handicapped

The need for optometric vision care for handicapped people is discussed. The high incidence of functional vision problems among the disabled population is presented. A vision clinic operated jointly by the New England College of Optometry and the Cotting School, a school for physically disabled children, is described. Suggestions for achieving successful involvement with the vision care of disabled people are presented.

Two-week aerosol inhalation study on polyethylene glycol (PEG) 3350 in F-344 rats.

PEGs in the 3000 to 4000 MW range are used in many pharmaceutical and cosmetic applications; they produce little ocular or dermal irritation and have extremely low acute and subchronic toxicity by oral and dermal routes of administration. However, little information exists on the potential of aerosols of these materials to produce adverse health effects. F-344 rats were exposed to aerosols of PEG 3350 (20% w:w in water) at 0, 109, 567, or 1008 (highest attainable) mg/m3 for 6 hr/d, 5 d/wk for 2 wk. No exposure-related toxicity was found with regard to clinical signs, ophthalmology, serum chemistry, urinalysis, or gross pathology. Exposure-related effects included: a 50% increase in the neutrophil count (males only) at 1008 mg/m3; decreased body weight gain (16%) for both the 567 and 1008 mg/m3 groups (males only); absolute lung weights of both sexes were increased 10 and 18% for the 567 and 1008 mg/m3 groups, respectively. A slight increase in the number of macrophages in the alveoli was the only change observed histologically in all PEG 3350-exposed groups. Therefore, inhalation of aerosols of PEG 3350 at concentrations up to 1008 mg/m3 produced relatively little toxicity in rats, the lung was the target organ, and the no-observable-effect-level was between 109 to 567 mg/m3.

A Multidisciplinary Approach to Orbital Neoplasm

The patient with orbital and periorbital neoplasia requires careful assessment of the extent and biologic activity as well as histopathologic categorization. Treatment is optimal through a multidisciplinary approach involving the ophthalmic surgeon, plastic surgeon, neurosurgeon, head and neck surgeon, and oral surgeon.

Vision care in a juvenile detention facility.

Optometry plays a key role in the provision of vision care services at the San Bernardino Juvenile Hall (SBJH), where 400 juvenile offenders, aged 12 to 18 years, are incarcerated. This program in San Bernardino, California, was established in 1979 by a practicing optometrist with support from federal, state, and local funding agencies. It operates as an outreach clinical program to train senior students of the Southern California College of Optometry for professional practice opportunities in a nontraditional setting. An important component of the SBJH program is an ongoing clinical research program to study the relation between vision problems and juvenile delinquency, and the effect of vision training on the rehabilitation of delinquent youths. Preliminary data indicate a reduction in the recidivism rate for this population group.

Symposium paper:Vision Care for Migrant Workers

Migrant vision care, although encompassing only a small percentage of the population, presents a unique opportunity to the profession through the schools and practitioners. The need for care has been shown through several demonstration projects; viable practice modes have been developed that offer cost-effective care to this population.

AMA President-Elect Rallies Ophthalmologists at AAO Meeting

AMA President-Elect Rallies Ophthalmologists at AAO Meeting

Surgery of the Eye: Volumes I & II

Surgery of the Eye is a two-volume text edited by six prominent ophthalmologists. The sections are General Considerations, Cataract, Cornea, Glaucoma, Plastic Surgery, Strabismus and Pediatric Ophthalmic Surgery, and Retina. Few procedures commonly done by ophthalmic surgeons are not addressed. The editors begin with the statement of purpose, which is provide a single text that elucidates the most commonly utilized ophthalmic surgical techniques and serves as an authoritative reference work for ophthalmic In my opinion, this goal is achieved in some sections but not in others. ... a single text that elucidates the most commonly utilized ophthalmic surgical techniques... While reading this book one is reminded that in the past decade the great increase in technology and mechanization has changed almost the entire field of ophthalmic surgery. Formerly, one was able to sit down with an atlas, review the procedure to be done from diagrams and photographs, and be

Atlas of Ophthalmic Surgery, Volume II: Cornea, Glaucoma, Lens

This is the second volume in a three-volume series. first volume covers lids, orbits, and extraocular muscles, and the second covers retina and vitreous. This book was designed to provide beginning and experienced ophthalmic surgeons with clear, concise descriptions of anterior segment surgical procedures, and it achieves this goal. For a multiauthored text it is well organized and consistent in both quality and format. Individual chapters were written by 18 accomplished ophthalmic surgeons. main contributors include David Paton, MD, Herbert Kaufman, MD, Marguerite McDonald, MD, George Spaeth, MD, Klaus Heilmann, MD, G. O. H. Naumann, MD, Douglas Koch, MD, C. Steven Foster, MD, and David Mark, MD. A great attribute of the book is that all 561 illustrations were created by a single artist, which enhances the cohesiveness of the book. many black-and-white drawings in each chapter are of first-rate quality. The drawings alone make this book

Centenary celebration of Fick's Eine Contactbrille.

This year marks the centenary of the clinical application of the contact lens. Although previous writers had speculated as to the possibility of directly neutralizing the cornea with a variety of often-impractical optical devices, 1 it was Adolf Eugen Fick (Figure) who first described the process of fabricating and fitting scleral contact lenses—first on rabbits, then on himself, and finally on a small group of volunteer patients. 2 Fick's article was originally published in German in the journal Archiv fur Augenheilkunde (current title: Graefes Archive for Clinical and Experimental Ophthalmology ) in March 1888. It was translated by Charles May, 3 the noted New York ophthalmologist, and published simultaneously in theArchivesbecause at that time these were sister journals, both of which were edited by H. Knapp and C. Schweigger. The article is truly remarkable since Fick made a number of observations and recommendations that are still valid today; for

Epikeratophakia--a new procedure in refractive surgery of the cornea

The epikeratophakia operation developed by Kaufman represents an additional procedure in refractive surgery of the cornea. The application of individually prepared corneal tissue lenticles on top of the recipient cornea can be used in refractive (Keratolens) and tectonic (Keratopatch) problems. The most important indication for this operation is monocular aphakia in which a contact lens is not tolerated. As is pointed out in the literature, postoperative visual acuity is reduced in some patients by interface densities and incomplete epithelialization. The advantage of this newly developed method is that it offers the ophthalmic surgeon a novel procedure for the indications mentioned which does not involve any major investment in apparatus.

Ophthalmic Irrigants: A Current Review and Update

The search for an ideal intraocular irrigating solution is of paramount importance to te ophthalmic surgeon. An intraocular irrigating solution, as well as surgical technique, can have deleterious effects on ocular tissues. Since an intraocular irrigating solution comes in contact with the cornea, lens, trabecular meshwork, uvea, vitreous, and retina, and ideal irrigant would be ome that ensures biological function for all of these tissues. In a practical sense, the best irrigant is one that causes the least possible damage to the structural integrity and function of the intraocular environment. This paper summarizes the development, uses, and efficacy of intraocular irrigating solutions as currently used during intraocular surgery.

Book Reviews: Clinical Ophthalmology edited by Sir Stephen Miller. Published in 1987 by IOP Publishing Limited, Bristol, England, 599 pages, $116.75

Book Reviews: Clinical Ophthalmology edited by Sir Stephen Miller. Published in 1987 by IOP Publishing Limited, Bristol, England, 599 pages, $116.75

Clinical Ophthalmology: A Text and Colour Atlas

<i>Clinical Ophthalmology: A Text and Colour Atlas</i>is an introductory text primarily intended for the nonophthalmologist physician, medical student, and others looking for a short yet well-rounded overview of the specialty. While boasting numerous superb color photographs, however, this book is more than just an atlas. The ophthalmologic examination, symptom-related diagnosis, and common pathologic conditions affecting the eye are addressed in a succinctly written fashion. The book comprises 15 chapters. The first discusses the techniques and instrumentation used for the eye examination. Special attention is given to direct ophthalmoscopy. After brief chapters devoted to refractive errors, color vision defects, and aging changes in the eye, a well-illustrated review of eyelid conditions is presented. In this latter section, as throughout the book, the photographs are reproduced in an appealing and clearly illustrative manner. The subsequent chapters deal with the causes of epiphora and the red eye, briefly discussing both common and

Binocular interaction and steady-state visual evoked potentials. I. A study in normal subjects and in subjects with defective binocular vision.

A correlate of binocular-neuron activity was found in some properties of visual evoked potentials (VEPs), such as facilitation (defined as a binocular response greater than the sum of the monocular responses) and changes in latency (shortening of binocular VEP latency as compared to that of monocular VEPs). Monocular and binocular steady-state VEPs in response to phase-alternating gratings of different contrast and both spatial and temporal frequency were recorded in three normal subjects. Fourier analysis of the responses was performed to isolate the component at the reversal frequency. Binocular VEPs showed facilitation in the low-contrast range (3%-10%). Facilitation was highest for gratings that had spatial frequency of 0.6-2 cycles/degree (c/d), alternating at 16 reversals per second. Phase shortening was found across a parameter range larger than that at which amplitude facilitation occurred. These results suggest that both amplitude facilitation and phase shortening in binocular VEPs may provide an objective measure of binocular visual function in clinical ophthalmology.

Eye Injuries: An Illustrated Guide

Eye Injuries: An Illustrated Guide offers a unique overview of the evaluation and management of patients suffering ocular trauma. It is intended for residents and fellows in ophthalmology. Moreover, it would also be of value to practicing ophthalmologists who encounter acutely injured patients only infrequently, medical students during their clinical ophthalmology experience, and emergency care physicians. Certainly, physicians at any level will appreciate its broad scope and clear presentation. Eye Injuries: An Illustrated Guide distinguishes itself from other trauma books in its novel design. Borrowing the popular format of other Gower projects, the text closely parallels and details numerous color clinical photographs. The photographs are superb—approximately five per page, clear, and beautifully illustrative of the wide range of ocular trauma. The accompanying text acts as a guide to the workup and management of such patients. The text comprises ten chapters. The first discusses basic examination techniques as well as

Optical therapy in primary binocular vision care: a case study

In a mildly amblyopic anisometrope with a high AC/A ratio, esotropia was corrected by prescribing maximum plus lenses. By altering spectacle lens parameters and reducing the diameter of the spectacle lenses, aniseikonia was reduced while maintaining cosmetic acceptability. The vertical imbalance was partially compensated without the need for bicentric grinding by leaving the patient with a small left hyperphoria in the primary position and a slight right hyperphoria at the near visual point.

BOOK REVIEWS

Book reviewed in this article: KERATOPROSTHESES S. N. Fyodorov, Z. I. Moroz, V.K. Zuev. VITREOUS MICROSURGERY Steve Charles. 1987—YEARBOOK OF OPHTHALMOLOGY Edited by J. Terry Ernest and Thomas A. Deutsch. CLINICAL OPHTHALMOLOGY Edited by Sir Stephen Miller.

Management of Ocular, Orbital and Adnexal Trauma

Eye trauma is a common problem that all practitioners of clinical ophthalmology must be prepared to deal with effectively and efficiently. Subspecialists in ophthalmology become generalists once again as anterior segment, posterior segment, neuro-ophthalmic, and orbital/plastic problems must all be addressed in a single patient. In addition, since eye injury often occurs in the setting of multiple system trauma, the ophthalmologist must also be prepared to co-manage patients with neurosurgeons, plastic surgeons, otolaryngologists, oromaxillofacial surgeons, and general surgeons.<i>Management of Ocular, Orbital and Adnexal Trauma</i>strives to present a multidisciplinary approach in the care of periorbital trauma. Consistent with the backgrounds of the editors, Thomas Spoor, MD, and Frank Nesi, MD, place a strong emphasis on orbital and adnexal trauma. Two thirds of the book is devoted to neuro-ophthalmic trauma, orbital injuries, fractures, and eyelid trauma. There is a good deal of material beyond the practical application of the general