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Query: UMLS:C0038379 (strabismus)
 9,317 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The alternatives in the management of infantile glaucoma refractory to conventional treatment are quite limited and unrewarding. We did a retrospective study of 49 patients (53 eyes) under 12 years of age with advanced, uncontrolled glaucoma who each underwent implantation of a single-plate Molteno implant in one stage. Over the follow-up period ranging from 6 months to 3 years (mean 18 months), 36 of the 53 eyes (68%) had an intraocular pressure less than or equal to 21 mm Hg and were considered a success. Fourteen eyes (26%) required further glaucoma surgery, 2 eyes developed severe chronic hypotony, and 1 eye lost light perception following endophthalmitis. The number of anti-glaucoma medications was decreased from a mean of 2 (+/- 1) to 1 (+/- 1). The probability for success of the Molteno implant in controlling glaucoma increased with the age of the patient. Six eyes (11%) were late failures, most probably due to fibrous encapsulation of the bleb. Complications observed were: prolonged hypotony and flat anterior chamber, retinal detachment, migration of the tube, erosion of the tube through the conjunctiva, and an ingrowth of fibrous tissue in the anterior chamber. We consider the Molteno implant to be a reasonable option in the management of difficult cases of infantile glaucoma.
J Pediatr Ophthalmol Strabismus
PMID:Clinical experience with the Molteno implant in advanced infantile glaucoma. 205 Dec 91

Study of the combinations of symptoms and signs contributing to the clinical picture of edematous exophthalmos (EE) and orbital pseudotumor (OP) has helped single out 14 classes, each of them reflecting the subjective or objective status of a patient. An 0 to 4 score rating inside each class permits ruling out this or that symptom (0 score) or assess its severity (1-2; 3-4 scores). These classes comprise patients' complaints, the status of the periorbital tissues, upper lid and bulbar conjunctiva, the degree of the eyeball protrusion, eye mobility and strabismus angle, and changes in the intraocular pressure and fundus oculi. Analysis of the symptoms markedness in scores for each of the 14 classes, carried out with due consideration for the process stage separately for EE and OP, has shown that the total score is under 6 in the initial stage of the disease and 17 in the decompensation stage. The score drastically rises in the far progressed stages of both EE and OP, being 23-29 in EE and 22-27 in OP. The authors emphasize that the suggested rating helps objectively assess the process stage in each case and thus choose the treatment strategy.
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PMID:[A method of evaluating the clinical course of edematous exophthalmos and pseudotumor of the orbit]. 236 42

To evaluate whether a more extensive incision of the tissue adjacent to the anterior trabecular meshwork resulted in more effective control of intraocular pressure (IOP), seven infants with bilateral congenital glaucoma underwent a single goniotomy in one eye and two simultaneous goniotomies at separate sites in the second. Sodium hyaluronate (Healon) was used in all eyes undergoing two simultaneous goniotomies and in three to seven eyes undergoing a single goniotomy. Success was not significantly different, at 1 month or 1 year postoperatively, for eyes which underwent two simultaneous and separate goniotomies. Successful control of IOP was, however, related to the preoperative IOP. Eyes for which the initial procedure was unsuccessful had a significantly higher IOP. The incidence of postoperative hyphemas was less in eyes in which the Healon was used intraoperatively, but the use of Healon did not favorably or adversely affect intraocular pressure control.
J Pediatr Ophthalmol Strabismus
PMID:One versus two simultaneous goniotomies as the initial surgical procedure for primary infantile glaucoma. 291 15

Biofeedback therapy has been shown to be of value in the treatment of numerous psychological and physiological problems. In this paper, applications of biofeedback for correction of oculomotor abnormalities including strabismus, nystagmus and amblyopia, refractive error correction, reduction of intraocular pressure (IOP), and blepharospasm suppression are reviewed.
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PMID:Ophthalmic applications of biofeedback. 354 37

Multiple modalities of treatment for traumatic hyphema have been advocated in the past. Therapy should be directed at reducing the risk of secondary hemorrhage and the potentially devastating complications of corneal blood staining and optic atrophy. Therapeutic regimens proven successful include: a patch and shield to the traumatized eye; daily visual acuity and slit-lamp biomicroscopy, including intraocular pressure, evaluation of corneal clarity, and size of hyphema; topical atropine; the systemic administration of aminocaproic acid; and topical and systemic antiglaucomatous medications with elevated intraocular pressure. Surgical intervention should generally be avoided in hyphemas of less than 50%. In larger hyphemas, there are definite indications for surgical intervention. Preferred surgical methods include: irrigation and aspiration, and hyphema evacuation by vitrectomy instrumentation.
J Pediatr Ophthalmol Strabismus
PMID:Traumatic hyphema. 395 78

The differential diagnosis of leukocoria (pseudoglioma) in the neonate includes multiple conditions, including malformations with retinal dysplasia as a component. Typically bilateral, retinal dysplasia is characteristically seen in microphthalmic eyes. Certain chromosomal defects have been described. The case reported herein presented in the first month of life with an enlarged eye, elevated intraocular pressure, prominent iris vasculature, and leukocoria. Family history was positive in one respect: this is the second child of a Viet Nam veteran exposed to Agent Orange. The first child, from a different mother, also had birth defects. Other than his left eye, the child is completely normal. Ultrasonography showed posterior vitreous opacities of indeterminate configuration. CT scan suggested a posterior intraocular mass. Histologically, the principal features were an anomalous, largely unformed corneoscleral angle, intraocular hemorrhage, and retinal dysplasia. Light microscopic studies were performed. The corneoscleral angle revealed an anteriorly inserted iris with an absence of trabecular meshwork and Schlemm's canal. This case is considered unique on the basis of the association of retinal dysplasia with congenital glaucoma and larger-than-normal eye. The significance of reported paternal exposure to Agent Orange in this instance is unknown.
J Pediatr Ophthalmol Strabismus
PMID:Congenital glaucoma and retinal dysplasia. 404 44

Quantitative techniques of measuring ocular motor function have proven extremely useful in evaluating the strabismus patient. The forced duction test has been valuable in determining the extent of mechanical restrictions and, in some instances, indirectly provides information about muscle strength. The active force generation test is a direct measure of active muscle force, while the differential intraocular pressure test (which may be easier to perform) provides data on active force indirectly. Saccadic velocity studies reveal the presence of muscle paresis or paralysis as contrasted with restrictions. Several neuro-ophthalmic conditions have typical eye movement patterns that are helpful in identifying them correctly. Saccadic velocity tests can also be helpful in diagnosing a disinserted extraocular muscle. Quantitative studies assist in more accurate diagnosis and are helpful in therapeutic decision making in terms of the timing and type of therapy indicated.
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PMID:Quantitative evaluation of the strabismus patient. 407 17

The clinical efficacy of Efemoline eyedrops [fluourometholone (0.1%) + tetryzoline (0.25%)] and of fluorometholone 0.1% was investigated in a double-blind controlled clinical trial in 35 patients (63 eyes) in treatment of the upper bulbus area and postoperatively after surgery for cataract, glaucoma and strabismus. Both drugs were effective inflammation inhibitors. The superiority of fluorometholone + tetryzoline over fluorometholone was evident: subjective symptoms improved much more quickly. No tendency toward elevation of intraocular pressure was found. The combined preparation was compatible and produced no side-effects.
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PMID:[Fluorometholon/tetryzoline in the treatment of conjunctival irritation]. 636 44

A clinicopathological case report of a black male with congenital glaucoma is presented. The child died at age three months of the Sudden Infant Death Syndrome. The clinical course was characterized by persistent corneal clouding and elevated intraocular pressure in spite of vigorous medical and surgical therapy. Histopathological findings included corneal enlargement, marked hypoplasia of the canal of Schlemm, poorly developed scleral spur, insertion of the ciliary musculature directly into the trabecular meshwork anterior to the scleral spur, and anterior displacement of the iris root. There was also anomalous dispersion of the sphincter muscle of the iris from the pupillary margin almost to the iris root, and attachment of some ciliary processes to the posterior surface of the iris. A poor clinical response to conventional glaucoma therapy, including trabeculotomy, goniotomy, trabeculectomy and medical therapy, supports the belief that the marked hypoplasia of Schlemm's canal was a major factor contributing to the elevated intraocular pressure. Furthermore, the multiplicity of abnormalities of anterior chamber angle structures suggests that some cases of congenital glaucoma may result from an early and extensive disorder in the formation of anterior segment tissues.
J Pediatr Ophthalmol Strabismus
PMID:Congenital glaucoma unresponsive to conventional therapy: a clinicopathological case presentation. 663 49

Differential intraocular pressure offers a painless, non-invasive, reliable test for evaluating incomitant strabismus. These data can be used in selecting a recess-resect vs. a muscle transfer procedure and, combined with findings of the traction test, can direct the surgeon in doing a full tendon transfer or a rectus muscle union with recession of the antagonist.
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PMID:Differential intraocular pressure as an indirect measure of generated muscle force. 689 22


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