11/23. optic nerve massaging: an extremely rare cause of self-inflicted blindness.PURPOSE: To report a patient whose self-inflicted blindness was not clinically apparent by history or external signs of trauma. DESIGN: Observational case report. methods: A 12-year-old girl with a history of social and behavioral problems was noted to have visual loss in her right eye. Examination revealed no light perception, optic nerve atrophy, partial upper lid ptosis, exotropia, and hypoesthesia of the cheek, all on her right side. RESULTS: After undergoing extensive examinations which were unrevealing for a diagnosis, the patient admitted to a recurrent maneuver, which she secretly used to relieve anxiety and stress. This maneuver consisted of inserting her index finger under the right supraorbital rim and forcibly subluxating her globe out of the orbital space. CONCLUSIONS: Self-inflicted visual loss can occur in nonpsychotic and nonviolent patients. Accurate diagnosis is important, as there is a risk of similar involvement to the fellow eye, and referral for psychiatric counseling is mandatory.- - - - - - - - - - ranking = 1keywords = visual (Clic here for more details about this article) |
12/23. Characteristic ocular findings in patients with craniofacial cleft.PURPOSE: To identify the characteristic ocular findings in patients with craniofacial cleft (CFC). methods: Ophthalmologic examination was performed for a 16-year-old girl with no. 3 CFC and a 3-year-old boy with no. 5 CFC. RESULTS: exotropia was found in the 3-year-old boy with no. 5 CFC involving the lateral orbit, and esotropia in the 16-year-old girl with craniofacial cleft no. 3 involving the medial orbit. Hypotropia, lower eyelid coloboma, amblyopia and an absence of stereopsis were common to both patients. visual acuity was improved from hand motion to 20/30 by means of occlusion therapy for amblyopia in the 3-year-old boy. strabismus surgery resulted in exophoria of 8 prism diopters (PD) in the 3-year-old boy and left esotropia of 8 PD in the 16-year-old girl. CONCLUSIONS: amblyopia, hypotropia, esotropia (no. 3) and exotropia (no. 5) should be verified in cases of CFC nos. 3 and 5. Ophthalmologic examination and early intervention for amblyopia may be mandatory for patients with CFC involving the orbit.- - - - - - - - - - ranking = 0.20209288188447keywords = acuity (Clic here for more details about this article) |
13/23. amblyopia due to inflamed chalazion in a 13-month old infant.Meibomian gland cysts (chalazia) are very common lesions in childhood and are not thought of as visually threatening lesions. A case is reported of dense amblyopia and secondary exotropia resulting from an upper eyelid chalazion.- - - - - - - - - - ranking = 0.5keywords = visual (Clic here for more details about this article) |
14/23. The need for optometric investigation in suspected Meares-Irlen syndrome or visual stress.Meares-Irlen syndrome is characterised by symptoms of eye strain, headaches and visual perceptual distortions when viewing text. The symptoms are alleviated with individually prescribed coloured filters, such as precision tinted lenses. Meares-Irlen syndrome, and the related condition of visual stress, are likely to result from hyperexcitability of the visual cortex, which can also occur in migraine. The symptoms of Meares-Irlen syndrome and visual stress are non-specific and the condition needs to be differentially diagnosed from other optometric conditions, such as refractive error, binocular vision anomalies, and accommodative anomalies. Three case reports are described of patients who consulted the author with suspected Meares-Irlen syndrome but were found to have other causes for their symptoms: posterior sub-capsular cataract, high uncorrected astigmatism, and decompensated convergence weakness exophoria. These cases highlight the need for professional eye care for people with suspected Meares-Irlen syndrome. Although this advice is stressed in literature on the well-established MRC/Wilkins Intuitive Colorimeter system, it is not always stressed in literature about other systems. This may be a cause for concern.- - - - - - - - - - ranking = 4keywords = visual (Clic here for more details about this article) |
15/23. Cavernous hemangioma of the retina in a pediatric patient.A 4-year-old girl had a cavernous hemangioma of the retina in the right eye. A vitreous hemorrhage associated with this lesion caused amblyopic exotropia. Although this lesion has been considered harmless, it may cause visual impairment in the pediatric patients.- - - - - - - - - - ranking = 0.5keywords = visual (Clic here for more details about this article) |
16/23. endophthalmitis after strabismus surgery with a good visual result.A 78-year-old woman underwent recession-resection surgery for longstanding exotropia. A scleral perforation occurred at the time of surgery and was treated with transscleral retinocryopexy. Three days after surgery the patient experienced light perception vision, pain, and hypopyon. She underwent a trans pars plana vitrectomy with intravitreal and periocular antibiotics. Three months after vitrectomy, visual acuity returned to the preoperative level of 20/50. Six months after vitrectomy she underwent an uneventful cataract extraction with posterior chamber lens implant. visual acuity 5 months after cataract surgery was 20/20.- - - - - - - - - - ranking = 3.8588545298082keywords = visual acuity, visual, acuity (Clic here for more details about this article) |
17/23. Form vision deprivation amblyopia: further observations.Nine cases of esotropia occurring in deprivation amblyopia, where exotropia rather than esotropia is usually found, showed a refractive error of hypermetropia. This fact suggested that an accommodative factor is largely responsible for the development of esotropia. A- or V-pattern strabismus was encountered in a higher incidence in deprivation amblyopia than in ordinary strabismus. Pattern-reversal VEP showed more prominent abnormality than flash VEP did. Studies of the sensitive period of the visual system revealed that the sensitivity is likely to be low for a month or two after birth and increases with a peak around the 18th month of age, decreasing thereafter with a waning slope to the end of the 8th year of life.- - - - - - - - - - ranking = 0.5keywords = visual (Clic here for more details about this article) |
18/23. Infantile exotropia with homonymous hemianopia: a rare contraindication for strabismus surgery.A homonymous hemianopia can be compensated by a strabismus in the direction of the visual field defect if the deviated eye has a harmonious anomalous localization. This compensation is only partial; its extent corresponds to the angle of deviation. We report on two patients with a hemianopia to the left. Under binocular conditions the visual field defect was reduced by an exotropia of the left eye with panoramic vision. Unfortunately, up to now it has not been possible to induce such a sensory-motor compensation in cases of homonymous hemianopia with normal retinal correspondence in an adult visual system.- - - - - - - - - - ranking = 1.5keywords = visual (Clic here for more details about this article) |
19/23. Accommodation deficiency in healthy young individuals.Ten patients, ages 10 to 19, with accommodation insufficiency are reported. All patients were in good health and asymptomatic, except for asthenopia during near visual activities. Each patient's amplitude of accommodation was measured and found to be considerably below the minimal normal for their respective ages (an average of 6 diopters). Only three patients had associated convergence insufficiency. No etiology for the diminished accommodation was suggested by history or could be identified by careful examination. All patients were successfully managed optically with bifocals or reading glasses, although three required the addition of base-in prisms for the near exodeviation. Near vision testing and determination of the near point of accommodation should be part of the pediatric ophthalmologic examination in all patients with complaints referable to their reading and visual performance at near.- - - - - - - - - - ranking = 1keywords = visual (Clic here for more details about this article) |
20/23. Unilateral disc-shaped cataract with coloboma of lens.A case of unilateral disc-shaped cataract with coloboma of the lens is reported. The patient, a 17-year-old girl, had best corrected visual acuity of 0.01 ( 9 D) in the right eye and 1.2 in the left eye. exotropia of 10 Hirschberg degrees was found in her right eye. The visual disturbance of that eye was thought to be due to amblyopia. The pupillary center of the lens was very thin and membranous, with no nucleus. A ring-like hypertrophic cataract was observed from the lens equator to the periphery of the pupillary area. A bow-shaped coloboma of the lens was found from 3 to 5 o'clock, where the Zinn's zonule was coarse. Some dozen bright white spots were dispersed temporally from the periphery of the macular ring. This combination of disc-shaped cataract with the coloboma of lens is the first such case reported.- - - - - - - - - - ranking = 2.1567616479238keywords = visual acuity, visual, acuity (Clic here for more details about this article) |
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