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Query: UMLS:C0086543 (cataract)
 29,165 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The first one was a 13 months old lewish boy with typical features of the rhizometic type; clinicaly the patient demonstrated cataract, esotropia, nystagmus, malnutrition, micromelia, contracture, multiple stippled calcifications about the periphery of the cartilagenous structures of the vertebral bodies, sternum, wrists, knees, heels, ribs; and profound mental retardation, After cataract operation, the head of the optic nerve demonstrate to be narrower than usualy and white. Pathologic studies of the lens' fragments after surgery showed the cataract to be without any specific characters. The child now 2 yrs and 1/2 old is still alive but in poor condition. The second was a 16 months old Arabic boy without typical features but with a cataract and stippled calfications of a limited number of epiphysae. Pathologic studies of the lens after cataract surgery showed the cataracts to be without any specific characters, the optic nerves were normal. The child now 3 yrs old is normally developed and in good conditions. It is remarquable to note that in both cases there was an history of consanguinity (mother and father were first cousins).
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PMID:[Two cases of chondrodysplasia punctuate are reported]. 14 72

Fifty patients with aphakia and strabismus were studied. The chief complaint was diplopia following full optical correction. Prism therapy was recommended if the diplopia persisted after 3 to 4 months. When prism therapy was ineffective or impractical, surgery was recommended. The result of therapy was not influenced by the cause of the cataract treatment was considered successful in approximately 80% of patients. Patients who had convergence insufficiency did well with prism therapy alone. Half of the patients who had divergence excess needed extraocular-muscle surgery. One fourth of the patients had esotropia, nearly half associated with lateral rectus palsy. While prism therapy resulted in fusion, a reduction in prism power was not tolerated in this group. For this reason, surgery was suggested for all patients who had esotropia.
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PMID:Strabismus in the aphakic patient. 55 97

A retrospective study (coauthored with Geraldine Tillson) of 118 patients with the congenital esotropia syndrome is described. All patients were aligned with surgery and, in some cases, glasses as well, within 10 prism diopters of orthotropia before the age of 2 years and had remained so aligned for at least a year. A standardized final examination was performed on patients over the age of 6 years, after at least 5 years' follow up, to study the effect of significant refractive error, amblyopia, nystagmus, dissociated vertical divergence, and inferior oblique overaction on the sensory outcome. None of the patients obtained central fusion. Fifty-three of 118 obtained peripheral fusion with at least 5 delta of fusional amplitude. Twenty-eight of the 53 fusers had stereopsis. The findings did not show any factors to explain why 65 did not obtain fusion. A congenital lack of the potential to develop fusion is postulated. The development of fusion and suppression is discussed with relevant references. Evidence is presented that the anatomical location of the lesion in central fusion disruption is in the midbrain. Fusion may be lost, in visual adults, without developing suppression from prolonged sensory deprivation. Examples include unilateral cataract, uncorrected unilateral aphakia, and unilateral severe herpetic keratitis.
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PMID:18th annual Frank Costenbader Lecture. Fusion and suppression: development and loss. 158 79

We studied all cases of strabismus surgery performed at the Manhattan Eye, Ear and Throat Hospital between January 1, 1981 and June 30, 1986. Of the procedures, 106 (5.4%) were performed on patients over the age of 60 years. Strabismus in patients over age 60 represents a category of diseases which are different from those of childhood. Horizontal deviations were seen in 74% of the patients equally divided between esotropia and exotropia. Vertical strabismus was seen in 17%, and a combined vertical horizontal strabismus was seen in 9% of patients. In children, the overwhelming majority of ocular deviations are horizontal, with esotropias outnumbering exotropias. The strabismus was of adult onset in 71% of cases and of childhood onset in 29% of the patients. The etiology in the adult onset strabismus group included neuroparalytic, restrictive, sensory, and post-cataract surgery strabismus, as well as decompensated exophoria/intermittent exotropia; this was in contrast to children where the most common etiology of strabismus is innervational disturbances in fusional vergences. The major indications for surgery were diplopia and aesthenopia in 71% of cases. Diplopia is uncommon in childhood. Corrective surgery for the relief of diplopia may be enhanced with the use of adjustable sutures and postoperative prism therapy. Precise realignment is the goal of strabismus surgery in all age groups, however, the role of adjustable sutures and prisms is more important in the treatment of the functional complaints of older patients. Exploration and lysis of adhesions and scar tissue are major components of surgery on patients with restrictive strabismus.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Strabismus in patients over the age of 60 years. 201 55

Strabismus surgery is indicated for a variety of conditions stemming from misalignment of the eyes, abnormal head posture, and nystagmus. Although part of the value of such surgery lies in the fact that it improves appearance, it differs from cosmetic surgery, because, unlike the latter, it is designed to restore only normal configuration for ocular alignment--straight and/or aligned with the object of regard. A wide array of diagnostic tests are used to determine the precise treatment required, the goal of which is to provide comfortable vision, normal head position, and normal human appearance. In some cases nonsurgical techniques can be used to treat strabismus, but there is no evidence that visual training is an effective means of straightening eyes in those cases where surgery is considered the treatment of choice. For the most common strabismus, essential infantile or "congenital" esotropia, 80+% of infants have "straight" eyes after the initial operation, and 90% after a second operation, most of these with "straight eyes" have residual deviation of 5 prism diopters of esotropia or less. More than 50% of surgically treated patients have stable, long-term satisfactory results. Considering the effort required on the part of the ophthalmologist, together with the physical and psychological benefit to the patient, the cost of strabismus surgery should be equal to that of any major ophthalmic surgical procedure. That strabismus surgery is compensated at a lower rate, than for example, cataract surgery, suggests that strabismus surgery is an excellent value.
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PMID:The value of strabismus surgery. 211 13

Optical correction of high hypermetropia with glasses is the primary treatment for accommodative esotropia. These glasses are often poorly accepted by adolescents and young adults for they are cosmetically undesirable, heavy, and esotropia occurs with their removal. We report an 11 1/2-year-old, physically mature female with high hypermetropia and accommodative esotropia corrected to orthophoria with glasses who was unable to be weaned from her glasses. She became intolerant to glasses wear, refused contact lenses, and was treated successfully with bilateral phakic hypermetropic epikeratoplasty. Two years postepikeratoplasty her visual acuity is 20/40 and 20/20 uncorrected and the vision in the amblyopic right eye has remained at its maximum preoperative level. She is orthophoric at distance and has a 2 prism diopter monofixational esophoria at near without glasses. Epikeratoplasty is an option in the treatment of accommodative esotropia for patients who are past the amblyopia forming age, have a stable angle of strabismus, and who require their full hypermetropic optical correction to maintain orthophoria.
J Cataract Refract Surg 1990 May
PMID:Bilateral phakic hypermetropic epikeratoplasty for accommodative esotropia. 235 24

The frequency and polarity of secondary strabismus was related retrospectively to the onset of deprivation in 131 children with mono- and bilateral aphakia after congenital cataract or perforating injury. The frequency was highest in patients up to 2 years of age at the onset of deprivation. From the 3rd year on, it declined to 50% or less. Esotropia was predominant in the first 2 years of life. At the end of the first decade of life exotropia was up to 80%.
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PMID:[The association of strabismus and aphakia in children]. 235 76

We describe the binocular status of four patients, aged 5, 6, 10, and 13 years, who had a unilateral congenital cataract removed in the first few months of life. A contact lens had been fitted in all cases and was worn continuously. The normal eye was occluded for approximately 90% of the waking day until at least the age of 4 years. Two patients developed an esotropia and two an exotropia. Best-corrected visual acuity is 20/40 or better in both the aphakic and the normal eye. The patients' binocular status was assessed with a full eye examination, tests for fusion in free space with prism neutralization, tests for stereopsis, and examination on the Clement Clarke synoptophore. All patients showed simultaneous perception but no real fusion, resulting in diplopia. A vertical bobbing effect was noted at the angle of neutralization similar to that reported by us in cases of central fusion disruption.
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PMID:Unilateral congenital cataract: binocular status after treatment. 270 79

The treatment program for form-vision deprivation and strabismic amblyopia currently followed in our orthoptic clinic is presented. In unilateral congenital cataract, a disease that causes form-vision deprivation amblyopia, good vision up to 20/20 can be obtained through surgery performed before the patient reaches 8 weeks of age, employing new surgical techniques such as lentectomy and vitrectomy, combined with early aphakic eye correction and occlusion of the healthy eye. In strabismic amblyopia, prevention and/or early treatment are very important, particularly in cases of unilateral infantile esotropia. Our success rate with occlusion therapy was 84.6% using a patch and 83.3% employing atropine cycloplegia. Occlusion therapy is monitored with the preferential looking technique to prevent the development of occlusion amblyopia. The visual prognosis for amblyopia due to unilateral congenital cataract and infantile strabismic amblyopia has been improved compared with previous reports. The prognosis for binocular function remains poor.
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PMID:Form-vision deprivation amblyopia and strabismic amblyopia. 336 Mar 52

Investigation of the binocular functions in 25 patients with bilateral aphakia having undergone the two cataract operations at intervals ranging from 1 to 11 years. Only in 4 patients was the unilateral aphakia corrected temporarily by contact lenses. By the alternating cover test it was found that, after the second operation, 3 patients showed an esotropia and 14 an exotropia or exophoria for distant sight and 23 an exotropia or exophoria for near sight. Over one-third of the patients not having worn any contact lenses had no simultaneous vision at the Bagolini test for distant sight and more than half of them had no simultaneous vision for near sight. There was no stereoscopic vision for distant sight in nearly 50% of the patients and no stereoscopic vision for near sight in more than half of those who had not worn any contact lenses. The early fitting of contact lenses or the immediate lens implantation in elderly patients together with the prescription of spectacles for near work in the case of unilateral aphakia prevent the weakening or the loss of binocular functions.
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PMID:[Binocular function in patients with several years' interval between cataract operation on the first and second eye]. 361 45


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