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

A consecutive series of 38 eyes of 35 glaucoma patients treated with transillumination guided cyclocryotherapy (CCT) either to obtain pain relief or to achieve IOP control was studied at Helsinki University Eye Hospital. Transillumination was used to guide the applications to the correct site. The follow-up range was 1-43 months (mean 9 months). Pretreatment IOP was 39 +/- 13 mm Hg and postoperative 26 +/- 16 mm Hg (mean +/- SD). Twenty-three eyes underwent one and 15 eyes 2-5 procedures. IOP control (IOP 9-23 mm Hg) was achieved in 50%. The response was more favorable in eyes without iris neovascularisation (59% achieved IOP control) than in eyes with neovascular glaucoma (38% achieved IOP control). The best response was achieved in eyes with chronic uveitis (5/7 eyes achieved IOP control). Repeated procedures improved the IOP control rate. Hypotony (IOP < 9 mm Hg) without clinical signs of phthisis occurred in three eyes (8%). Thirteen eyes needed primarily pain relief and 92% achieved it. Postoperatively vision was better in 8%, unchanged in 37% and worse in 55%. Visual acuity was 0.05 or better in nine eyes pretreatment and in eight eyes after treatment.
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PMID:Transillumination guided cyclocryotherapy in the treatment of secondary glaucoma. 128 52

Cryocoagulation was used to treat 21 eyes with neovascular glaucoma. In 6 eyes, cyclocryocoagulation was used as an independent method and in 15 eyes cyclocryocoagulation and following transscleral panretinal cryocoagulation in one session. The author has followed up the postoperative development of the intraocular pressure, pain in the eye, rubeosis iridis, and the central visual acuity. Markedly better results were achieved by the author by using the combined cryosurgical method. The author assumes the cause of the unsatisfactory final central visual acuity to be the rather late treatment of the neovascular glaucoma-most of the patients were operated on 2 to 3 weeks after the acute increase of the intraocular pressure. A good final central visual acuity was achieved in patients who were operated on immediately after the acute increase of the intraocular pressure. After the use of the combined cryosurgical intervention, we noted in all the patients: within 3 days normalization of the intraocular pressure in all the patients, on the first postoperative day a marked relief from pain in all the patients and, also in all the patients, a marked regression of rubeosis iridis within 6 weeks after operation.
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PMID:Cryosurgery in neovascular glaucoma. 134 5

The authors give an account of the long-term results of cryotherapy of neovascular glaucoma in 15 eyes of 12 patients with proliferative diabetic retinopathy. The operation was repeated in three instances (20%). Cyclocryothermy was used nine times, cyclocryothermy with retinal transconjunctival cryocoagulation also nine times. Within five days after operation the intraocular pressure was compensated in all patients. Within six months after cryotherapy the intraocular pressure rose above 21 Torr (2.799 kPa) in three eyes. After repeated cryosurgery the intraocular pressure in these eyes was normal. In the remaining 12 eyes at the end of the observation period--average 14.7 months--the intraocular pressure was within the range of 4.8-20.6 Torr (0.639-2.746 kPa). The pain in the eye receded in 100% of the patients. After operation eventually in all patients rubeosis receded. Deterioration of eyesight after the operation is ascribed to the duration of the high intraocular pressure and gradual progression of the proliferative diabetic retinopathy.
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PMID:[Cryotherapy of neovascular glaucoma in diabetics]. 136 51

The author summarizes the present knowledge concerning the treatment of pain in neovascular glaucoma. The treatment of the pain is very closely connected with a good compensation of the intraocular pressure. The author did not find a correlation between the degree of the elevated intraocular pressure and the ocular pain. He compares the results of the treatment of ocular pain in neovascular glaucoma with cyclo-cryocoagulation as a single method with those of the method of trans-scleral panretinal cryocoagulation in combination with cyclo-cryocoagulation performed in one session. In the treatment of ocular pain, markedly better results were achieved by using trans-scleral panretinal cryocoagulation in combination with cyclo-cryocoagulation. Complete relief from pain was achieved the fifth postoperative day in 54.5% when only cyclo-cryocoagulation was performed, in 100% when trans-scleral panretinal cryocoagulation was carried out in combination with cyclo-cryocoagulation. According to the author, this stands in connection with the better compensation of the intraocular pressure after the combined cryosurgical intervention and, in all probability, also with the assumed analgesic effect of panretinal cryocoagulation, which is obviously due to damage to the sensitive nerves of the bulb during freezing of the sclera an the choroid.
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PMID:Painful eye in neovascular glaucoma and its treatment with cryocoagulation. 136 53

The authors evaluate the therapeutic results of pain of the eyes and the development of visual acuity of 38 eyes with neovascular glaucoma treated by cryocoagulation. In 12 eyes they used cyclo-cryocoagulation as an independent method and in 26 eyes the method of transscleral panretinal cryocoagulation combined with cyclo-cryocoagulation. The authors did not find a correlation between the degree of increased intraocular pressure and the painfulness of the eye. In the treatment of pain they achieved markedly better results when using transscleral panretinal cryocoagulation than cyclo-cryocoagulation alone. The better therapeutic results of treatment of pain by combined cryosurgery is associated with a better compensation of intraocular pressure. In the authors' view a significant in the treatment of pain is also played by the newly described so-called analgetic effect of panretinal cryocoagulation which develops probably as a result of damage of sensitive nerves of the bulbus during freezing of the sclera and the choroid. The development of the so-called analgetic effect is probably associated with two facts: relief from severe pain was perceived also by patients where during the early postoperative period a high intraocular pressure still persisted and also in patients where a high intraocular pressure rose again. This condition was, however, as a rule not associated with the onset of new pain. The use of transscleral panretinal cryocoagulation combined with cyclo-cryocoagulation achieved regression of pain within 5 days after operation in 100%. The author provide evidence that the visual acuity in neovascular glaucoma recedes very rapidly and irreversibly.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[5 years' experience in the treatment of neovascular glaucoma using cryocoagulation. II. Treatment of pain and the development of visual acuity]. 139 28

We report a prospective evaluation of the effect of anterior retinal cryopexy on 62 eyes with neovascular glaucoma. Pain was relieved and anterior chamber inflammatory reaction regressed dramatically in 95%. Iris neovascularization was reduced or regressed in 93.5%. Control of intraocular pressure was clinically significant in 82.3% 1 year after the procedure, especially in patients with pretreatment pressures less than 40 mm Hg on maximal medical therapy. Anterior retinal cryopexy is recommended in eyes with media opacities and as a preliminary procedure for filtering surgery in eyes with neovascular glaucoma.
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PMID:A prospective evaluation of anterior retinal cryoablation in neovascular glaucoma. 171 28

Pain around the eye can be caused by local ophthalmic disorders or by disease of other structures sharing trigeminal nerve sensory innervation. In general, most ocular causes for pain also cause the eye to be red, thus alerting the examiner to the focality of the problem. However, conditions like eyestrain, intermittent angleclosure glaucoma or neovascular glaucoma, and low-grade intraocular inflammation can be painful and not be associated with obvious redness. Ocular signs and symptoms also occur with numerous other causes of headache. Double vision in association with periocular pain can result from orbital lesions, isolated cranial neuropathies, and cavernous sinus lesions. Pupillary abnormalities like Horner's syndrome may result from a variety of painful conditions, including cluster headache, parasellar neoplasms or aneurysms, internal carotid dissection or occlusion, and Tolosa-Hunt syndrome. Pain with a dilated and unreactive pupil may reflect a benign condition like Adie's syndrome or ophthalmoplegic migraine, or it may herald the presence of a life-threatening posterior communicating artery aneurysm. Headache and transient visual loss can be manifestations of classic migraine, or be symptoms of ocular hypoperfusion from ipsilateral internal carotid occlusion or increased intracranial pressure from pseudotumor cerebri. In a young patient, head pain with a fixed visual deficit may result from optic neuritis, in an older adult, temporal arteritis may be the culprit. Ophthalmologic aspects of headache thus encompass problems that range from simple and benign to complex and formidable.
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PMID:Ophthalmologic aspects of headache. 202 Feb 23

Melanoma involving the ciliary body is a rare tumor which carries a poor prognosis when compared to all uveal melanoma. We have treated 54 patients with ciliary body melanoma using helium ions from 1978 to 1985. Because of the high rate of metastatic disease, the 5-year disease specific survival rate is only 59% despite a 5-year local control rate of 98%. The greatest diameter of the tumor was predictive of loss of vision and enucleation (p = .05, p = .04, respectively). Multivariate analysis showed that the greatest diameter of the tumor was the most important predictor of death from metastases. The incidence of neovascular glaucoma at 5 years is 43%. The 5-year actuarial rate of enucleation is 26%. Enucleation was done for pain and/or neovascular glaucoma. Univariate analysis showed treatment volume to be a statistically significant predictor for the development of neovascular glaucoma (p = .0017) and enucleation (p = .0078). Seventy percent of neovascular glaucoma occurred in patients with treatment volume greater than 5.5 cc. Seventy-four percent occurred in patients with an initial ultrasound height greater than 9.2 mm. Using this information, patients at high risk for neovascular glaucoma could be considered for prophylactic treatment with panretinal photocoagulation.
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PMID:Ciliary body melanoma treated with helium particle irradiation. 211 91

Carotid arterial disease may result in a variety of ischemic ocular problems that can eventually lead to permanent blindness. From 1984 to 1988, 18 patients underwent reconstruction of the carotid artery in an attempt to restore normal retinal arterial flow and, thereby, reverse or prevent progression of ischemic oculopathy. During a mean period of 21 months after carotid arterial reconstruction, subjective improvement in vision as well as a resolution in eye and periorbital pain was reported in 87.5 per cent of the patients. Measured visual acuity improved or stabilized in 94.4 per cent; macular photostress recovery times improved in 87.5 per cent, funduscopic examinations noted improvement or resolution in ischemic signs in 93.3 per cent and intraocular pressures improved in two of three patients. One patient experienced recurrent episodes of amaurosis fugax, which resolved after two weeks and did not recur. A second patient experienced an increase in intraocular pressures with visual deterioration, required laser photocoagulation after which the condition of the patient stabilized but only after significant visual impairment. Carotid arterial reconstruction is effective for the treatment of ischemic oculopathy and is most beneficial if performed early, before the onset of irreversible neovascular glaucoma.
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PMID:Carotid endarterectomy for chronic retinal ischemia. 224 84

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


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