1/232. Optic disc topographic changes post-trabeculectomy visualized by anaglyphs.BACKGROUND: publications on changes of optic disc topography usually illustrate their findings with two-dimensional images. methods: With the introduction of computerized imaging, anaglyphs of stereo images can be produced for illustrations. Anaglyphs are viewed three-dimensionally with red-green spectacles that are included in refraction sets and are normally used to assess phoria. An anaglyph of progressive, glaucomatous progression is included to demonstrate the method, along with conventional colour images. RESULTS: We present two cases of severely altered optic disc topography post-trabeculectomy and illustrate these cases with anaglyphs that can be viewed three-dimensionally. CONCLUSION: Three-dimensional viewing of illustrations assists with the visualization, perception and interpretation of optic disc changes.- - - - - - - - - - ranking = 1keywords = visual (Clic here for more details about this article) |
2/232. Accommodative blur in pilocarpine-treated glaucoma.Accommodative blurring of distance visual acuity is a common problem among young patients being treated for glaucoma with pilocarpine. A single case is reported in which a clip-on prescription was given to alleviate such problems. The development of accommodative blur following instillation of pilocarpine is monitored. The dioptric changes required to restore distance acuity to 20/20 are also monitored.- - - - - - - - - - ranking = 0.2keywords = visual (Clic here for more details about this article) |
3/232. Ocular amyloidosis and secondary glaucoma.OBJECTIVE: To report the clinical and histopathologic findings in two cases of secondary glaucoma associated with amyloidosis. DESIGN: Two case reports. methods: Retrospective review of clinical findings, course, and treatment of the two patients. The histopathologic findings from available biopsy material were also reviewed. MAIN OUTCOME MEASURES: intraocular pressure (IOP), visual field changes, and surgical outcome. RESULTS: The first case describes a 76-year-old woman with orbital amyloidosis who developed gradual unilateral elevation of IOP that was poorly responsive to medical therapy and underwent filtration surgery. Episcleral venous pressure was elevated on the affected side, and histopathologic analysis of the conjunctival tissue confirmed perivascular amyloid deposits, further suggesting raised episcleral venous pressure to be a possible mechanism of glaucoma. The second case describes a 47-year-old white woman with familial amyloid neuropathy with a transthyretin cys-114 mutation. The association of glaucoma with this mutation has not been described previously. Persisting elevation of IOP in one eye was initially responsive to topical antiglaucoma medications but eventually required filtration surgery. Amyloid particles were found in the aqueous and on the lens surface. Histopathologic analysis of the aqueous and sclerectomy specimens demonstrated amyloid, suggesting outflow obstruction as a possible mechanism of glaucoma. Conjunctival buttonholing complicated filtration surgery in both cases, and the leaks eventually resolved with good control of IOP. CONCLUSIONS: Amyloid associated with glaucoma may involve different pathophysiologic mechanisms. The elevated IOP may not respond well to medical therapy. Cautious surgical manipulation of the conjunctiva is warranted in these cases.- - - - - - - - - - ranking = 0.2keywords = visual (Clic here for more details about this article) |
4/232. hyphema associated with pupillary dilation in a patient with exfoliation glaucoma and warfarin therapy.PURPOSE: To describe an unusual hemorrhagic complication associated with pupillary dilation in a patient with exfoliation glaucoma taking anticoagulation therapy. methods: A 78-year-old woman with bilateral exfoliation glaucoma who was receiving warfarin, 2 mg daily, for systemic anticoagulation developed acute visual loss in the right eye several hours after pupillary dilation. RESULT: Examination disclosed bilateral advanced exfoliation glaucoma, localized vascularized iridolenticular adhesions in the right eye, and a 4-mm layered hyphema in the right eye. CONCLUSION: patients with exfoliation glaucoma and vascularized posterior synechiae who are receiving anticoagulation therapy are at increased risk for visually significant spontaneous hyphema after pupillary dilation.- - - - - - - - - - ranking = 0.4keywords = visual (Clic here for more details about this article) |
5/232. Surgical management of coexisting pseudophakic bullous keratopathy and glaucoma.This technique is a 1-step surgical management approach for patients with pseudophakic bullous keratopathy, glaucoma, and an unsatisfactory intraocular lens (IOL). The outcome of 4 consecutive patients who had penetrating keratoplasty, IOL removal, vitrectomy, transscleral sutured IOL implantation, and trabeculectomy by the same surgeon were reviewed. All patients had had intracapsular cataract extraction with anterior chamber IOL implantation and were on antiglaucoma therapy. Main outcome measures were Snellen visual acuity and intraocular pressure. A 1-stage quintuple procedure can achieve relatively rapid visual rehabilitation in these high-risk eyes. The role of filtration surgery is controversial, but it was partially successful in controlling postoperative intraocular pressure.- - - - - - - - - - ranking = 0.4keywords = visual (Clic here for more details about this article) |
6/232. Transpupillary argon laser cyclophotocoagulation in the treatment of traumatic glaucoma.PURPOSE: A patient with traumatic glaucoma who underwent transpupillary argon laser cyclophotocoagulation for management of uncontrolled intraocular pressure (IOP) despite maximally tolerated medical therapy is discussed. methods: In this patient, pars plana vitrectomy, lensectomy, and removal of 180 degrees of necrotic iris had been performed after a blunt trauma with a bungee cord. Six weeks after surgery, the patient presented with an IOP of 40 mmHg despite therapy with three aqueous suppressants. The patient refused further surgical intervention and opted for transpupillary argon laser cyclophotocoagulation (talc). The laser setting was 1,000 mW, with a 50-micron spot size for 0.1 second. A total of 293 laser exposures through a Goldmann contact lens was administered to all visible ciliary processes over 180 degrees where iris structures were absent. RESULTS: Ten weeks after talc, the patient's IOP remained controlled with medications at 16 mmHg, and visual acuity had improved to 20/25 with an aphakic contact lens. CONCLUSION: In selected patients whose ciliary processes are visible with indirect gonioscopy due to the defect in the iris, talc may be an effective alternative cyclodestructive procedure to lower IOP when conventional medical or laser treatments are not successful.- - - - - - - - - - ranking = 0.2keywords = visual (Clic here for more details about this article) |
7/232. persistent hyperplastic primary vitreous with myopia: a case study.BACKGROUND: persistent hyperplastic primary vitreous (PHPV) is a congenital disorder that manifests a range of ocular anomalies, including leukocoria, microphthalmia, cataract, and a retrolental fibrovascular membrane. In general, the prognosis for visual acuity with PHPV has been poor. A recent report on six patients who have myopia associated with PHPV showed that these patients were not microphthalmic, did not manifest leukocoria, and showed a mean visual acuity at final followup of 20/160. CASE REPORT: The case of a 3-year-old boy with myopic PHPV of the left eye is presented. Full-time wear of the cycloplegic refraction, combined with patching of the non-amblyopic eye, resulted in an improvement in visual acuity. RESULTS: PHPV with myopia may constitute a distinct subtype of PHPV. patients with myopic PHPV tend to seek treatment later than patients with anterior or posterior PHPV as a result of the lack of microphthalmia and leukocoria. These individuals do not show the long-term complications, such as secondary glaucoma and intraocular hemorrhages, associated with PHPV. CONCLUSION: The acuity improvement in this case of myopic PHPV suggests that a more conservative approach to its surgical management may be appropriate while pursuing refractive correction and amblyopia therapy to attain the best acuity possible.- - - - - - - - - - ranking = 0.6keywords = visual (Clic here for more details about this article) |
8/232. Combination of autologous blood injection and bleb compression sutures to treat hypotony maculopathy.PURPOSE: To report successful use of a combination of autologous blood injection and bleb compression sutures to treat overfiltration with hypotony maculopathy after trabeculectomy with mitomycin C. methods: Two patients underwent the combined procedure and were followed until visual acuity and intraocular pressure (IOP) were stable over three consecutive visits (4 to 9 months). RESULTS: Both patients experienced improvement in visual acuity both subjectively and objectively, and both patients had an elevation in IOP that persisted over three consecutive visits. CONCLUSIONS: Combination autologous blood injection and bleb compression suture placement may be an effective means of treating hypotony maculopathy after trabeculectomy with mitomycin C.- - - - - - - - - - ranking = 0.4keywords = visual (Clic here for more details about this article) |
9/232. vitrectomy for phacolytic glaucoma in a patient with homocystinuria.PURPOSE: To determine the successful treatment of unilateral phacolytic glaucoma by vitrectomy and trabeculectomy in a patient with homocystinuria whose lens had dislocated into the vitreous at least 15 years earlier. methods: In a 32-year-old woman with homocystinuria, bilateral dislocation of the lens into the vitreous, and phacolytic glaucoma in her left eye a three-port pars plana vitrectomy was performed with the patient under general anesthesia. The lens was removed and a trabeculectomy fashioned. Special precautions for general anesthesia included preoperative aspirin and compression stockings for thromboembolic prophylaxis and intraoperative dextrose infusion, 5%, to maintain intravascular volume and prevent hypoglycemia. RESULTS: The intraocular pressure and uveitis resolved postoperatively with improvement in the visual acuity and intraocular pressure, which returned to normal without further treatment. CONCLUSIONS: Phacolytic glaucoma is best resolved by removal of the exciting lens material. Pars plana vitrectomy with the patient under general anesthesia can be carried out safely despite the risks traditionally associated with homocystinuria.- - - - - - - - - - ranking = 0.2keywords = visual (Clic here for more details about this article) |
10/232. Ocular toxicity of systemic medications: a case series.BACKGROUND: There are many visually threatening conditions that may result from long-term use of systemic medications. Many of these adverse side effects can be greatly reduced or prevented with close monitoring of patients. In view of current knowledge, updated clinical guidelines for appropriate monitoring of ocular toxicity from systemic medications need to be developed for the eye care practitioner. CASE review: There have been many reports of ocular toxicity from isoniazid, thioridazine, steroids, and amiodarone therapy. Clinical cases illustrating possible adverse ocular side effects are presented, which include INH-induced optic neuropathy, phenothiazine-induced retinopathy, steroid-induced glaucoma, and vortex epitheliopathy secondary to amiodarone. CONCLUSION: Optometrists should be aware of the potential for ocular side effects from systemic medications. eye care guidelines for monitoring ocular side effects from thioridazine, INH, steroids, and amiodarone use are suggested.- - - - - - - - - - ranking = 0.2keywords = visual (Clic here for more details about this article) |
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