1/12. Bilateral cataract surgery combined with implantation of a brown diaphragm intraocular lens after trabeculectomy for congenital aniridia.A 17-year-old male patient was referred for poorly controlled glaucoma on maximal medication, congenital aniridia, cataract, nystagmus, and hypoplasia of the macula. A bilateral filtering procedure was performed to control the glaucoma. Three months later, a slow motion phacoemulsification and implantation of a brown diaphragm intraocular lens (IOL) was attempted. Despite the presence of nystagmus and hypoplasia of the macula, the visual acuity improved from 20/300 to 20/100 in the right eye and from 20/400 to 20/150 in the left eye. Both aniridia IOLs were well centered, the anterior segment was quiet with normal intraocular pressure without medication, and all of the patient's glare symptoms disappeared. A single-piece iris diaphragm and optical lens offer a safe alternative for patients who previously had no viable options for iris reconstruction. The most serious postoperative problem, glaucoma, should be addressed before the cataract and lens implantation is performed to avoid a possible acceleration of the glaucoma progression by the large aniridia IOL.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/12. nursing care of the cataract patient: today's outpatient approach.Total cataract patient care encompasses nursing assessment, clinical management, emotional support, and the accessibility of the nurse to the patient. Because ophthalmic nurses develop a close relationship with the cataract patient, they are often the first health care professional the patient calls for advice. Patient education and adequate time to listen and respond are integral components in an outpatient cataract surgical approach. All aspects of the nursing care of the cataract patient provide challenge and satisfaction as the ophthalmic registered nurse experiences surgery with the patient and supervises the return to improved vision and quality of life. The nurse must always remember that there is a whole person attached to the eye. Although ophthalmic nursing is specialized and highly technical, patience, empathy, and encouragement are essential in the care of the patient before, during, and after cataract surgery.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
3/12. Late-onset corynebacterium endophthalmitis following laser posterior capsulotomy.Four months following uncomplicated cataract extraction, a patient underwent Nd:YAG laser posterior capsulotomy. Three days later, she presented with pain, hand motions vision, and severe anterior uveitis and vitritis. A coincident retinal detachment led to a delay in diagnosing the etiology of this intraocular inflammation. After recurrent episodes of inflammation that were initially responsive to corticosteroids, the patient underwent a vitrectomy, lens explantation, capsulectomy, and intravitreal antibiotic injections, which resulted in complete resolution of the intraocular inflammation with a best-corrected visual acuity of 20/60. corynebacterium species was ultimately cultured from the capsular tissue. The release of sequestered bacterial organisms must be considered in the differential diagnosis of persistent or unusually intense inflammation following laser posterior capsulotomy.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
4/12. Periodic alternating nystagmus clearing after cataract surgery.A 60-year-old man developed periodic alternating nystagmus in association with decreased vision due to cataracts. Prior to surgery, vision was limited to hand motion only in both eyes. An extracapsular cataract extraction with insertion of a posterior chamber intraocular lens was performed in the patient's left eye. On the first postoperative day, vision was 20/60 in the left eye and the nystagmus was absent with both eyes open. Periodic alternating nystagmus that occurs with poor vision is related to a loss of fixation. Surgery aimed at improving the visual status may be effective in extinguishing the nystagmus.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
5/12. epikeratophakia in children with traumatic cataracts.epikeratophakia provides a permanent optical correction for aphakia in children with congenital or traumatic cataracts; suturing the epikeratophakia graft onto the cornea eliminates the problems of contact lens or spectacle non-compliance in these young and generally uncooperative patients and provides tectonic support to scarred and irregular corneas. Eighteen children under the age of six years underwent epikeratophakia for the correction of aphakia after the removal of trauma-induced cataracts. Graft success rate was 88%; the average change in keratometry in the patients with successful grafts was 14.82 /- 2.0 diopters. In the 13 patients eligible for visual acuity tabulation, preoperative acuities ranged from light perception to 20/200, and postoperative acuities ranged from hand motions to 20/30. Ten (77%) had acuities of 20/80 or better. Poor results in three patients with less than 20/200 acuities were likely the results of non-compliance with amblyopia therapy. Present work indicates that in cases of traumatic cataract, the epikeratophakia procedure facilitates amblyopia therapy and decreases the astigmatism in scarred and irregular corneas.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
6/12. Long-term follow-up after accidental gamma irradiation from a 60Co source.In December 1973 a technician was accidentally irradiated when attempting to bring under control a sealed 60Co source (110 TBq) which had been lodged in the head of a medical irradiation unit during a replacement operation. In the early period after the accident, severe skin changes on the left hand, epilation in a small area of the left temporal region and minor deviations in peripheral blood developed. In the following years, repeated surgery due to secondary skin defects of the left hand resulted in the loss of the fingers 2-5. Since 1975, changes in the lens of the left eye began to appear leading gradually to the deterioration of visual acuity. Later, opacities of the lens of the right eye were found. The patient's psychological and emotional attitude about the accident changed in the course of time. The factors influencing the psychic state of the patient are identified.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
7/12. A new diabetic with complications: primary nursing care.Martha, an elderly patient, presented a real challenge to our nursing staff. As a new diabetic, she needed a great deal of education in addition to extensive nursing care for her multiple bleeding leg ulcers, dehydration and malnutrition due to uncontrolled diabetes, and reactive depression. Despite these problems, in approximately one month's time Martha was able to return to her home in control of her diabetes and her emotions and ambulating without pain. Her successful return to normal life was enhanced by holistic nursing management. The nursing staff found that the use of a problem list and a diabetes educational plan assisted them in individualizing their patient care.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
8/12. Cataract following radial keratotomy.An intumescent cataract developed 16 weeks after radial keratotomy in a 31-year-old man. corneal perforation was documented at the time of surgery, but no direct injury was noted to the lens capsule. visual acuity decreased to hand motions during a four-month course. Successful extracapsular cataract extraction occurred seven months following the original radial keratotomy. Soft contact lens correction of aphakia recovered a visual acuity of 6/6.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
9/12. Visually debilitating pterygium: surgical and contact lens treatment.PURPOSE: We present the management of a patient with large pterygia complicated by irregular astigmatism and corneal opacities. Visual rehabilitation required both surgical excision and contact lens fitting. methods: We examined a 30-year-old man with hand motion vision from a large pterygium overgrowing his right cornea. Histopathology was consistent with pterygium. During the first few postoperative weeks, his uncorrected visual acuity improved to 20/60, and manifest refraction yielded no further improvement. In the subsequent months, there were increasing anterior stromal corneal opacities, and the refraction became hyperopic to a variable degree. RESULTS: Best corrected visual acuity was 20/70-20/100. Axial length was 22.64 /- 0.07 mm. Computerized corneal topography 6 months postoperative was similar to the preoperative topography and revealed irregular and asymmetric astigmatism, with marked variation of the central corneal dioptric power. Slit lamp biomicroscopy suggested that the corneal opacities were responsible for the patient's decreased acuity; however, contact lens fitting provided 20/30 vision with a rigid gas permeable contact lens. CONCLUSIONS: The improved vision with contact lens therapy strongly suggested that the irregular and asymmetric astigmatism were more visually significant than the corneal opacities.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
10/12. A familial syndrome of congenital cataract, mental impairment, and dentate gyrus atrophy.We present a family with congenital cataract with, in some cases, mental retardation and emotional instability, but intellectual deterioration in all affected members. The latter was accompanied by psychosis in some. The inheritance is most likely autosomal dominant, affecting two generations and consisting of a congenitally blind parent and 6 of 11 of her offspring. In addition to these features, some affected individuals had dysphagia and movement disorder, especially choreiform movements. They all showed small body mass, due possibly to poor nutrition from dysphagia. The pathological findings were unique, demonstrating selective atrophy of the granule cell layer of the dentate gyrus. There was selective expression in paraffin-embedded sections of alpha B-crystallin (CRYA2) in oligodendroglia in all areas of the nervous system examined. alpha B-Crystallin is a major optic lens protein but also a heat shock protein and molecular chaperone found in brain and a number of other tissues. Because of the association of congenital cataract and the accumulation in oligodendroglia of alpha B-crystallin, the gene for this protein was sequenced for possible mutation. No mutation was found indicating other genetic locus. This family appears to have a newly recognized genetic disorder.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
| | Next -> |