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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acute angle-closure glaucoma from a spontaneous massive hemorrhagic retinal or choroidal detachment occurred in five eyes. The source of the hemorrhagic detachment was a disciform macular lesion in all instances. The mechanism for the angle closure is the abrupt forward displacement of the lens-iris diaphragm resulting from the massively detached choroid and retina. Four of the five patients had either systemic hypertension or a primary or anticoagulant-induced clotting disorder. All patients underwent ultrasonographic studies, and one patient had magnetic resonance imaging (MRI) to rule out melanoma. Only one eye required enucleation for pain relief. Glaucoma medication, cyclophotocoagulation, or retrobulbar alcohol controlled the other four eyes. The clinical, ultrasonographic, MRI, and histopathologic features of this rare condition are described, and an updated therapeutic approach is discussed.
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PMID:Acute angle-closure glaucoma from spontaneous massive hemorrhagic retinal or choroidal detachment. An updated diagnostic and therapeutic approach. 217 99

Advanced glaucoma in 140 eyes of 136 patients was treated with contact transscleral continuous wave neodymium:YAG (Nd:YAG) laser cyclophotocoagulation (CYC) with a sapphire-tipped probe. The anterior edge of the probe was placed 0.5 to 1.5 mm posterior to the limbus, using 7 to 9 W of power for 0.7 seconds with 32 to 40 applications, sparing the 3 and 9 o'clock meridians. Patients were studied prospectively. The mean preoperative intraocular pressure (IOP) of 36.7 +/- 0.97 mmHg decreased to 21.2 +/- 0.99 mmHg (P = 0.004) after treatment (mean follow-up, 3.2 +/- 0.35 months) for a mean decrease in IOP of 15.5 +/- 1.21 mmHg and a mean percent decrease of 39%. Forty-one eyes were followed 6 or more months (mean, 6.7 +/- 0.25 months). The CYC reduced IOP to 25 mmHg or less in 71% of eyes, to 22 mmHg or less in 62% of eyes, and to 19 mmHg or less in 49% of eyes. Maximum lowering of IOP occurred 1 week to 1 month after treatment and remained at that level through 6 months of follow-up. Retreatment was required in 11% of patients; only one patient was retreated more than once. Four patients treated with 9 W of power developed IOPs below 5 mmHg; two of these patients had an IOP of 0 mmHg. Other complications of therapy were minimal, and patients had little pain. There was no significant change in visual acuity. Early results of this newly available therapy are encouraging.
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PMID:Contact transscleral continuous wave neodymium:YAG laser cyclophotocoagulation. 218 92

There are conflicting reports on the value of cyclocryotherapy in the management of glaucoma. This retrospective study was carried out to assess the efficacy and complication rate of this procedure. The case notes of all patients undergoing cyclocryotherapy at a single centre over a 10-year period were reviewed. Case records were available for 68 eyes of 64 people. Thirty-eight eyes had neovascular glaucoma, nine had aphakic glaucoma, nine had angle closure glaucoma, three had primary open angle glaucoma, and nine had secondary open angle glaucoma. The mean follow-up periods for these groups varied from 2.0-6.3 years. The mean reduction in intraocular pressure following treatment varied from 7.9 mm Hg in the secondary open angle glaucoma group to 24.3 mm Hg in those with angle closure glaucoma. Pressure was controlled in 29.4% overall, ranging from 66.7% in the angle closure and primary open angle groups to 0% in the secondary open angle group. Of the painful eyes 71% were rendered comfortable, indicating that pain relief from cyclocryotherapy is not due solely to pressure control. 30% of the patients lost their vision following the procedure, phthisis occurred in 11.8% and four eyes (5.9%) went on to enucleation. Our results indicate that cyclocryotherapy affords good pain relief, without good pressure control, in various types of glaucoma. While there is an apparent high complication rate, visual loss and phthisis cannot be ascribed directly to the procedure, since these are eyes with a poor prognosis.
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PMID:Cyclocryotherapy: a review of cases over a 10-year period. 231 Jul 22

It was observed that in hypertension hearing is severely damaged. By analysis of the otological symptomatology in 50 hypertonic patients (42 women, 8 men) a bilateral hearing disorder was revealed in 47 subjects, a unilateral one in three subjects, otoscopy revealed dilatation of the artery supplying the handle of the malleus or even hyperaemia of Schrapnell's membrane. The patients reported low-frequency tinnitus, vertigo, pressure in the ears pain in the ears, headache, weather-dependence of complaints. In the initial stages roof-shaped type of audiometric curve was found, in the group were 45% mixed types of deafness. If during hypertension sodium is retained and the extracellular volume is enlarged, then in the inner ear the volume of perilymph increases in particular and this leads to impaired conduction through the inner ear fluids with affection of high and low frequencies, disorders of the conduction function of the fenestrae with the conduction component on the audiogram. Hypertension is for the organ of hearing an important risk factor in pre-disposed subjects with and affection of the inner ear is equally malignant and has a similar pathological background as glaucoma.
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PMID:[The cochleovestibular syndrome in hypertension]. 235 Aug 10

A White glaucoma pump-shunt was inserted in 16 eyes in 15 patients, 2 to 76 years of age (10 female and 5 male patients; 6 were white, 6 were black, and 3 were Hispanic). Six had primary open-angle glaucoma, 2 glaucoma in aphakia, 1 congenital glaucoma, 4 secondary glaucoma, 2 neovascular glaucoma, and 1 glaucoma in pseudophakia. There were no complete successes. There were five (31.3%) "qualified successes" (ie, an intraocular pressure less than or equal to 21 mm Hg on medical treatment, without pain, and without visual acuity loss of more than two Snellen lines). This qualified success rate is far below rates reported for other setons.
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PMID:Long-term results with the White glaucoma pump-shunt. 225 Aug 82

One hundred consecutive patients with intractable glaucoma underwent transscleral neodymium: YAG (Nd:YAG) cyclophotocoagulation using a standard protocol derived from a study of human autopsy eyes, and were followed prospectively for a minimum of 6 months. After the first treatment, 51 patients had a final intraocular pressure (IOP) between 7 and 20 mmHg (classified as "IOP success") and 17 more had an IOP less than 7 mmHg or more than 20 mmHg, but required no additional surgery ("qualified IOP success"). With one or more additional treatments, the totals rose to 65 IOP successes and 30 qualified IOP successes. Parameters associated with qualified success and failure were younger age and higher preoperative IOP. Forty-five patients in the cumulative IOP success and qualified IOP success groups had reduced visual acuity, although this could be attributed to other ocular problems in at least one half of the cases. Other postoperative complications included transient IOP rise in 23 patients, severe pain in 12 patients, and severe inflammation in 29 patients.
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PMID:Evaluation of a protocol for transscleral neodymium: YAG cyclophotocoagulation in one hundred patients. 238 6

33 patients (37 eyes) of neovascular and non-neovascular glaucoma were treated with cyclocryotherapy and followed up for 3-67 months, averaging 25 months. The IOP was brought under 2.73 kPa (21 mmHg) in 57.1% of the neovascular and 33.3% of the non-neovascular glaucomatous eyes, with an overall average IOP drop of 3.07 kPa (23.1 mmHg). Pain was controlled in 86.7% of the eyes. Cyclocryotherapy appeared to be an effective procedure for cases of refractory glaucoma, particularly those of neovascular origin. The complications and their mechanism were also discussed.
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PMID:[Cyclocryotherapy in the treatment of glaucoma]. 239 Sep 6

Retrobulbar injection of 1.0-2.5% aminazin solution in terminal painful glaucoma helps avoid enucleation in 83.8% of cases. The analgesic effect of retrobulbar aminazin does not always accurately correlate with its hypotensive action on the intraocular pressure. The mechanism of the drug action is explained by a local (on the ciliary node) manifestation of aminazin neurotropism depressing the eye sensitivity to pain.
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PMID:[Symptomatic treatment of terminal painful glaucoma by the retrobulbar administration of aminazine]. 259

Four patients with haemorrhagic glaucoma and 1 with secondary glaucoma were operated by the method of intrascleral sclerectomy with implantation of a polyethylene tube. After surgery all the patients showed a normalization of the intraocular pressure but in 2 persons it was transitory and after some months the IOP raised above 30 mm Hg. These patients however did not complain of pain and this was already a sort-of success in such severe cases.
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PMID:[Intrascleral sclerectomy with implantation of a polyethylene tube in hemorrhagic glaucoma. Preliminary report]. 262 41

The clinical results of penetrating keratoplasty for iridocorneal endothelial (ICE) syndrome are presented. Nine cases of penetrating keratoplasty for ICE syndrome were reviewed retrospectively. All grafts remain clear, with posterior corneal changes occurring in only one case, after a mean follow-up of 43 months. Penetrating keratoplasty produced visual improvement in 7 of the 9 cases, relief of pain in 6 of 6 cases, and prevention of further corneal infection in 1 case. We believe that penetrating keratoplasty has a place in the treatment regimen of this disease, not only to achieve improvement in vision, but also for relief of pain, and avoidance of recurrent corneal infections, and to allow a clear media for careful monitoring of optic disc and field changes in the associated glaucoma.
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PMID:Penetrating keratoplasty in the management of iridocorneal endothelial syndrome. 264 8


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