1/49. carbon monoxide poisoning causes optic neuropathy.PURPOSE: To describe the electrophysiological and psychophysical effects of carbon monoxide (CO) poisoning on visual function. methods: Three patients are presented who suffered CO poisoning, two due to suicide attempts and one in the course of a road traffic accident. After a full ocular examination, Goldmann visual fields, flash and pattern visual evoked potentials (VEPs) and flash and pattern electroretinograms (ERGs) were tested. RESULTS: electrophysiology showed reduced or absent N95 components of the pattern ERG and delayed, reduced VEPs. A positive-negative-positive (PNP) VEP waveform was seen in two cases. In one case, where presentation occurred at an early stage, visual and electrophysiological function was improved with hydroxycobalamine. CONCLUSIONS: The combination of ERG and VEP findings suggest that CO poisoning can cause a toxic optic neuropathy that may have a similar aetiological mechanism to that in tobacco amblyopia. Early treatment with hydroxycobalamine may be of some benefit.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/49. Human psychophysical analysis of receptive field-like properties: V. Adaptation of stationary and moving windmill target characteristics to clinical populations.This paper describes the application of several key parameters of a windmill-shaped target (used in determinations of the psychophysical transient-like function) to clinical populations as a diagnostic tool for static perimetry. A technique for independently analyzing sustained- (Westheimer function) and transient-like retinally-based psychophysical responses is outlined, and stimulus characteristics, reliability and diagnostic potential of the tests are examined. Several particularly interesting clinical cases (one closure of a branch retinal arteriole) and two senile macular degeneration patients) are presented for illustrative purposes. In addition, a tentative 'working hypothesis' is presented as a basis for extensive future analysis of various clinical populations.- - - - - - - - - - ranking = 6keywords = physical (Clic here for more details about this article) |
3/49. Long-term sequelae after surgery for orbital floor fractures.A surgical technique involving exact repositioning and rigid fixation is required for the reduction of fractures of the orbital floor. Even then, sequelae may be present long after the trauma. The aim of this study was to establish the frequency and type of sequelae after surgery for orbital floor fractures and to investigate the extent to which the method of surgery had any impact on the severity of the sequelae. A questionnaire was sent to all 107 patients (response rate 77%) 1 to 5 years after the injury. Further clinical data were obtained from the patients' charts. Eighty-three percent of the patients were affected by some kind of permanent sequelae in terms of sensibility, vision, and/or physical appearance. A high frequency of diplopia (36%) was related to the reconstruction of the orbital floor with a temporary "supporting" antral packing in the maxillary sinus, a technique which has now been abandoned at our department in favor of orbital restoration with sheets of porous polyethylene. Our conclusion is that, because long-term sequelae are common, the surgical technique must be subjected to continuous quality control to minimize future problems for this group of patients.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/49. brain imaging in a patient with hemimicropsia.Hemimicropsia is an isolated misperception of the size of objects in one hemifield (objects appear smaller) which is, as a phenomenon of central origin, very infrequently reported in literature. We present a case of hemimicropsia as a selective deficit of size and distance perception in the left hemifield without hemianopsia caused by a cavernous angioma with hemorrhage in the right occipitotemporal area. The symptom occurred only intermittently and was considered the consequence of a local irritation by the hemorrhage. Imaging data including a volume-rendering MR data set of the patient's brain were transformed to the 3-D stereotactic grid system by Talairach and warped to a novel digital 3-D brain atlas. Imaging analysis included functional MRI (fMRI) to analyse the patient's visual cortex areas (mainly V5) in relation to the localization of the hemangioma to establish physiological landmarks with respect to visual stimulation. The lesion was localized in the peripheral visual association cortex, Brodmann area (BA) 19, adjacent to BA 37, both of which are part of the occipitotemporal visual pathway. Additional psychophysical measurements revealed an elevated threshold for perceiving coherent motion, which we relate to a partial loss of function in V5, a region adjacent to the cavernoma. In our study, we localized for the first time a cerebral lesion causing micropsia by digital mapping in Talairach space using a 3-D brain atlas and topologically related it to fMRI data for visual motion. The localization of the brain lesion affecting BA 19 and the occipitotemporal visual pathway is discussed with respect to experimental and case report findings about the neural basis of object size perception.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/49. Optometric intervention in the control of juvenile delinquents.We are losing the battle against crime and delinquency and we have to continue to lose so long as we keep developing juvenile delinquents. In order to prevent crime, we have to prevent juvenile delinquency for criminals are not born, they develop from juvenile delinquents. research studies in Chattanooga, tennessee, show that the youngsters brought before the juvenile court have many different kinds of problems, but one problem that almost all have, other than the drug scene kid, is that they cannot read adequately. Many high school students are reading at first, second and third grade level; 91 percent to 94 percent of our juvenile delinquents are having reading and learning difficulties in the classroom. Consequently, they are all socially promoted and are facing the sting of failure which leads to truancy and conflict with school authorities. These children go from frustration to frustration and become behavior problems in the classroom. The teachers of the first, second, and third grades know which children are having difficulty with reading and will have possible behavioral problems, possibly becoming juvenile delinquents. This writer believes there are five essential preconditions which contribute to one's becoming a juvenile delinquent. Robert had them all: 1. Lack of proper supervision by the parents is the first precondition which contributes to juvenile delinquency. The family is the first and basic institution for the development of the child's emotional intellectual, moral, spiritual, physical and social behavior. 2. Improper discipline is the second factor. Experience teaches us that permissiveness should be controlled at an early age, and too much discipline is just as bad as too little discipline.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/49. Unilateral cone dysfunction with bull's eye maculopathy.OBJECTIVE: To report a Japanese subject who presented with an acute-onset, unilateral cone dysfunction with bull's eye maculopathy and to describe the functional changes determined by psychophysical and electrophysiologic tests. DESIGN: A single observational case report. methods: In addition to a complete ophthalmic examination, the subject underwent some electrophysiologic and psychophysical tests. MAIN OUTCOME MEASURES: Kinetic visual field test, cone and rod perimetry (two-color perimetry), full-field electroretinograms (ERGs), focal macular ERGs, and multifocal ERGs. RESULTS: The full-field ERGs and two-color perimetry showed a predominant loss of cone function in the right eye, whereas the left eye was normal. Cone perimetry and multifocal ERGs revealed that there were small regions functioning normally and other retinal areas that were severely altered in the right eye. CONCLUSIONS: The topographical function analysis suggested that the disorder affected the retina unevenly. The cause of this rare case of unilateral cone dysfunction with bull's eye maculopathy still remains unknown.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
7/49. Idiopathic central serous chorioretinopathy--a physical complication of stress?The adverse psychological sequelae of stress are well recognized by occupational health specialists. Potential adverse physical effects, such as ischaemic heart disease, are more contentious but are biologically plausible. This report outlines a case of idiopathic central serous chorioretinopathy (ICSC), an uncommon but potentially sight-threatening condition, which is widely accepted amongst ophthalmologists to be stress related. The condition is not referred to in standard occupational health texts or databases. The report includes a brief review of the ophthalmological literature on which the connection between ICSC and stress has been made, and a need for further research promoted.- - - - - - - - - - ranking = 5keywords = physical (Clic here for more details about this article) |
8/49. Hajdu--Cheney syndrome: evolution of phenotype and clinical problems.hajdu-cheney syndrome is a rare, autosomal dominant disorder comprising acroosteolysis of the distal phalanges with associated digital abnormalities, distinctive craniofacial and skull changes, dental anomalies, and proportionate short stature. The clinical and radiologic characteristics of hajdu-cheney syndrome develop and progress with age. Many of the medical problems that arise in this syndrome cluster in specific age ranges. case reports of six affected individuals in two additional families and a summary of the English literature is presented with emphasis on the changing physical findings and medical sequelae over time.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
9/49. The art of perimetry.There is no single method of perimetric examination which is applicable to all types of visual field defects. Perimetry is a subjective psychophysical sensory examination. It is not an exact science unless one includes the objective measurement of visual evoked response in the optic cortex. Until such a method becomes clinically available it will be necessary for the perimetrist to determine which techniques to use in a given case and to apply these techniques with sympathetic understanding. This is the art of perimetry.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
10/49. rehabilitation options for patients with low vision.Loss of vision has a profound effect on an individual's life. Reduced visual function, whether present at birth or appearing later in life, greatly affects one's perception of useful existence. When medical intervention can no longer restore or maintain a person's functional vision, rehabilitative measures are necessary to enable that person to adjust both physically and psychologically to his or her sensory loss. rehabilitation for low vision offers visually impaired individuals a renewed independence and productivity that will enable them to rejoin society as active participants. Often patients and healthcare providers are unaware of the rehabilitation options that are available to them. Low-vision devices such as magnifiers and telescopes, as well as counseling and vocational training, are among the available options. rehabilitation nurses are particularly qualified to identify patients with reduced functional ability and to recommend an appropriate visual assessment that can lead to maximized residual vision.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
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