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

A device and method for measuring forced vergence fixation disparity curves in clinical situations are described. Phoria, vergence, and fixation disparity are measures of different functions of the oculomotor system. In decreasing order of diagnostic effectiveness, four features of the fixation disparity curve are curve type, slope, Y-intercept, and X-intercept. Patients with exophoria and non-Type I curves are likely to have ocular discomfort. The steeper the curve, the more likely the patient is to have symptoms. However, Type IV curves are usually flat, and many of these patients do have symptoms. Patients with Type I curves respond well to visual training, but those with Type II curves generally need lenses or prisms to obtain relief. The Y-intercept gives information that is particularly useful in exophoric patients. A complete analysis of the oculomotor system requires measurement of both phoria/vergence and fixation disparity.
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PMID:Fixation disparity analysis of oculomotor imbalance. 742 86

We present a randomised, controlled study of a new approach to conjunctival incision in horizontal strabismus surgery. A peritomy is performed from 2 to 10 o'clock inferiorly allowing free access to the horizontal recti from below. No limbal stay sutures are required and the conjunctiva is left unsutured on completion of surgery. Results of 13 patients are presented. Each patient is paired with a control on whom conventional surgery was performed. The pairs were matched for age and surgeon. Results show a decrease in the time taken for the procedure and decreased discomfort in the post-operative period. The external appearance of the operated eye and the incidence of complications over a 6 week period were the same for both techniques.
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PMID:A novel conjunctival incision for horizontal strabismus surgery. 879 74

Six patients undergoing bilateral symmetric strabismus surgery were enrolled in this study. For each subject, incisions were closed with Vicryl in one eye and glue in the other. The conjunctival closure with the Vicryl suture resulted in increased discomfort and inflammation during the early postoperative period compared with fibrin glue. However, the difference between the Vicryl and the glue disappeared after 14 days.
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PMID:Conjunctival closure in strabismus surgery: Vicryl versus fibrin glue. 893 9

Remifentanil hydrochloride is a new, ultrashort-acting opioid metabolized by nonspecific plasma and tissue esterases. We conducted this multicenter study to examine the hemodynamic response and recovery profile of premedicated children undergoing strabismus repair who were randomly assigned to receive one of four treatment drugs (remifentanil, alfentanil, isoflurane, or propofol) along with nitrous oxide and oxygen for maintenance of anesthesia. Induction of anesthesia was by nitrous oxide, oxygen, and halothane or nitrous oxide, oxygen, and propofol. Anesthesia was then maintained with remifentanil 1.0 microgram/kg over 30-60 s, followed by a constant infusion of 1.0 microgram.kg-1.min-1, alfentanil 100 micrograms/kg bolus followed by a constant infusion of 2.5 micrograms.kg-1.min-1, propofol 2.5 mg/kg bolus followed by a constant infusion of 200 micrograms.kg-1.min-1, or isoflurane 1.0 minimum alveolar anesthetic concentration. The infusions of the anesthetics and the administration of the inhaled gases were adjusted clinically by predetermined protocols. Elapsed time intervals from the end of surgery to the time the patients were tracheally extubated and displayed purposeful movement, as well as the time the patients met the postanesthesia care unit (PACU) and hospital discharge times, were recorded. Heart rate and systolic and diastolic blood pressure were measured at fixed intervals. In addition, cardiovascular side effects (bradycardia, hypotension, and hypertension) as well as vomiting, pruritus, agitation, and postoperative hypoxemia were also noted. There were no significant differences in patient demographics among the treatment groups. There was no difference in the early recovery variables (times to extubation and purposeful movement) or the times to PACU and hospital discharge among groups. There were significant differences in side effects among the groups. Patients who received remifentanil had higher PACU objective pain-discomfort scores than those who received alfentanil and propofol. Patients anesthetized with alfentanil had a greater incidence in the use of naloxone and a greater incidence of postoperative hypoxemia compared with those anesthetized with remifentanil. The incidence of postoperative hypoxemia was the same for remifentanil, propofol, and isoflurane groups. There were no significant differences in the incidence of emesis among the four groups, and all four groups had similar hemodynamic profiles. We conclude that remifentanil appears to be an effective drug for anesthesia. Its hemodynamic and recovery profile appear similar to other comparable drugs. Based on previous pharmacokinetic studies, the 1.0 microgram.kg-1.min-1 infusion may be twice the 50% effective dose observed in adults. In this study, the relative "overdose" of remifentanil was well tolerated and did not prolong recovery.
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PMID:A randomized multicenter study of remifentanil compared with alfentanil, isoflurane, or propofol in anesthetized pediatric patients undergoing elective strabismus surgery. 914 19

Background: Controversy exists about the role of visual parameters and vision in learning to read. This study aims to determine whether ocular parameters or performance on a dynamic test of visual function differs for children of differing reading ability. Methods: Two hundred and eighty-four children (mean age 9.9 +/- 1.8 years) received a vision screening emphasising binocular anomalies associated with discomfort at near (distance and near visual acuity, distance vision challenged with binocular +1 D lenses, near heterophoria, near point of convergence, stereopsis and accommodative facility). Non-verbal mentation age and reading accuracy were assessed. One hundred and six children performed a computerised task of motion coherence detection. Children were classified as normal readers (n = 195), children with dyslexia (n = 49) or learning disabled children (n = 40) based on their mentation age and their reading age. Results: There were no statistically significant differences or correlations between visual parameters and reading performance. Over thirty per cent of the children had accommodative facilities below or equal to six cycles per minute. Children with learning disabilities performed worst on the motion coherence task but this was statistically significant only when compared to the performance of dyslexics. Discussion: The lack of association between ophthalmic parameters and poor reading ability supports the view of the Committee on Children with Disabilities. However, 39 per cent of the children might be expected to experience difficulty 'reading to learn', as suggested by the American Academy of Optometry, as they showed anomalies associated with visual discomfort with prolonged reading. The motion coherence test did not differentiate dyslexics from normal readers and was worst in children with learning disability. Accommodative facility testing remained the most useful predictor of potential visual discomfort.
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PMID:Is there an association between functional vision and learning to read? 1236 60

Thresholds for photophobia (light-induced discomfort) were determined at wavelengths from 440 to 640 nm for three subjects. Photophobia was assessed by means of electromyography, which was used to measure subjects' level of squinting. After correction for absorption by macular pigment and the ocular media, subjects' functions displayed a trend of increasing sensitivity with decreasing wavelength. We propose that the corrected function is indicative of increased sensitivity to potential retinal damage by short-wavelength light. It is therefore suggested that photophobia serves a function of biological protection. Results also suggest that photophobia is significantly mitigated by macular pigment in the short wavelengths.
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PMID:Action spectrum for photophobia. 1457 98

A hydrophilic implant for scleral buckling was developed in 1980. Advantages include softness and elasticity, no dead spaces, ability to gradually absorb and release antibiotics, and stimulating production of a fibrous capsule around the implant. Short-term fellow studies in rabbits showed no clinical or histologic complications. Long-term complications of the hydrogel scleral buckle have emerged in the las 10 years. These included fragmentation, subconjunctival bulging, intraocular erosion, migration, and restriction of extraocular movement. We recently encountered a patient with progressive restrictive strabismus beginning 8 years after retinal detachment repair with a MIRAgel (hydrogel; MIRA, Uxbridge, MA) scleral buckle. Worsening complaints of diplopia and discomfort led to strabismus surgery. Untreatable retinal detachment resulted in enucleation.
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PMID:Late-onset progressive strabismus associated with a hydrogel scleral buckle. 1497 Aug 5

A retrospective study of a consecutive series of 284 cases of strabismus surgery under local anesthesia is presented. A total of 284 operations on the extraocular muscles, performed with topical and subconjunctival application of local anesthetics-in some cases combined with anesthesiological sedation and monitoring-were analyzed retrospectively for adverse effects or complications caused by the type of anesthesia chosen. No ophthalmological complications caused by the mode of anesthesia and no vital complications occurred. In three cases, the intended surgery could not be fully completed due to discomfort of the patient caused by pain perception. In this case series, combined topical and subconjunctival anesthesia in strabismus surgery had a low frequency of complications.
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PMID:[Extra-ocular muscle surgery using combined topical and subconjunctival anesthesia]. 1529 Jan 96

Pronounced visual loss can lead to nystagmus, provoking oscillopsia and distressing ocular sensations. The treatment of acquired nystagmus remains difficult and various therapeutic options are attempted with limited results. We report the case of a man with acquired nystagmus and excessive ocular discomfort, successfully treated with repeated retrobulbar injections with botulinum toxin.
Binocul Vis Strabismus Q 2006
PMID:Repeated bilateral retrobulbar injection of botulinum toxin in a blind patient with retinitis pigmentosa and incapacitating nystagmus. 1706 61

To compare the anti-inflammatory and analgesic effects of topical pranoprofen 0.1% with diclofenac sodium 0.1% after strabismus surgery, 40 patients were prospectively randomized and assigned into 2 groups. Signs and symptoms of inflammation, as well as intraocular pressure (IOP) of patients, were evaluated at 1 day and 1 and 3 weeks following surgery. Both groups reported reduced inflammation and discomfort at 1 week, as compared to 1 day. There was no statistically significant difference in any measurement of postoperative inflammation (i.e., discomfort, chemosis, secretion, conjunctival hyperemia, and conjunctival gap size) between the 2 groups at any time. None of the patients developed an allergic reaction to the medications and IOP measurements were within the normal limits in both groups. Pranoprofen 0.1% was found to be as effective as diclofenac sodium 0.1% in reducing inflammation and pain after strabismus surgery. Pranoprofen could be used as a safe and effective anti-inflammatory alternative for the treatment of inflammation following strabismus surgery.
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PMID:Topical pranoprofen 0.1% is as effective anti-inflammatory and analgesic agent as diclofenac sodium 0.1% after strabismus surgery. 1759 12


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