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Query: UMLS:C0595921 (intraocular pressure)
 11,750 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Following the principles of classical Chinese acupuncture we treated 18 patients suffering from glaucoma chronicum simplex. We did not see any significant alterations of intraocular pressure whereas we attained improvement of recovery in some functional diseases such as blepharospasm or migraine. In our opinion therapeutic acupuncture works as a masked suggestive therapy. It is useless in organic diseases of the eye.
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PMID:[Acupuncture in glaucoma (author's transl)]. 73 93

Primary congenital glaucoma is a rare but potentially devastating disorder that family physicians must recognize as early as possible in infants and young children. Symptoms, which may not be present at birth, classically include photophobia, excessive tearing and blepharospasm. The cornea may be enlarged and hazy. Increased intraocular pressure rapidly damages the optic nerve in infants. Treatment includes surgery with regular follow-up evaluation.
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PMID:Primary congenital glaucoma. 271 97

A 4% pilocarpine gel applied topically to eyes was evaluated in glaucomatous Beagles and normotensive Miniature Schnauzers to determine its efficacy in reducing intraocular pressure (IOP) and to assess any side effects. Pilocarpine gel significantly (P less than 0.05) reduced IOP for 24 hours after treatment, compared with baseline (pre-drug) values, untreated fellow eyes, and placebo-treated eyes. The IOP remained significantly lower (P less than 0.05) during 3 treatment days, as well as the first 2 days after treatment. The pupil sizes were significantly smaller (P less than 0.01) in all treated dogs after the first administration of pilocarpine, compared with baseline values, untreated eyes, and placebo-treated eyes. The subsequent pilocarpine gel administrations induced significant miosis (P less than 0.01), compared with baseline values, but the extent of miosis and duration were significantly less (P less than 0.01) as the number of treatments increased. Conjunctival irritation and blepharospasm were observed mainly in the first 2 days of treatment and were minimal after subsequent applications. There was no contralateral effect on IOP or pupil size, compared with baseline values and placebo-treated eyes.
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PMID:Effects of 4% pilocarpine gel on normotensive and glaucomatous canine eyes. 271 87

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

Four cyclocryosurgical procedures were compared for effects on normal canine eyes. All procedures produced a significant (P less than 0.05) decrease in intraocular pressure, a marked uveitis, ciliary epithelial cell loss, edema and engorgement of the ciliary processes, iris necrosis, protein effusion, chemosis, and mild discomfort, as indicated by mild blepharospasm and slight epiphora. The histopathologic changes were evaluated at 5 minutes, 1 week, 1 month, and 6 months after surgery. The ciliary epithelium was normal in appearance and intraocular pressure had returned to the normal range at 6 months after surgery. The adverse reactions to the cyclocryosurgical procedures included retinal detachments, chemosis, conjunctivitis, transient increased intraocular pressure, uveitis, iris depigmentation, and corneal granulation tissue.
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PMID:Effects of cyclocryosurgery on the clinically normal canine eye. 683 8

The literature on the use of biofeedback techniques in the treatment of visual and ophthalmologic disorders is reviewed. Although this consists mainly of case studies, there is mounting evidence that biofeedback may be applicable to the treatment of strabismus, nystagmus, blepharospasm, elevated intraocular pressure, and myopia. because of the success in applying biofeedback techniques in the treatment of other neuromuscular disorders, it is concluded that the use of these techniques in the treatment of blepharospasm and strabismus shows the most promise.
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PMID:Biofeedback techniques in the treatment of visual and ophthalmologic disorders: a review of the literature. 703 90

Single doses (50 microliters) of 1% and 2% pilocarpine, instilled by a buffer-tip droptainer resulting in an approximate pH 7.0 solution, and 1, 2, and 4% pilocarpine, instilled by the standard droptainer, resulting a pH 5.0 solution, were evaluated in the glaucomatous Beagle model. Pupil size and intraocular pressure measurements were performed at 0, 1/4, 1/2, 3/4, 1, 2, 4, 6, and 8 hours. Signs of topical irritation (blepharospasm, conjunctival hyperemia and chemosis, and any corneal changes) were also monitored. Both solutions produced similar onset and duration of miosis and ocular hypotension, but the pH 5.0 solutions produced a brief elevation in intraocular pressure during the first hour post-drug instillation. Moderate blepharospasm, conjunctival hyperemia, and chemosis occurred with only the pilocarpine solutions with pH 5.0.
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PMID:Effects on intraocular pressure and pupil size in glaucomatous beagles after topical pilocarpine instilled with standard (pH 5) and buffer-tip (pH 7) droptainers. 909 Jun 10

Primary congenital glaucoma (PCG) is a rare genetic disease usually diagnosed during the first year of life. It occurs because of developmental anomalies of the chamber angle that prevents drainage of aqueous humor, thereby elevating intraocular pressure. Its incidence is 1 in 10,000 live newborns in Western societies and 1 in 1,200 live newborns in the Arab-Bedouin population of the Negev region in Israel. Most cases of PCG appear to be sporadic. The cytochrome P4501B1 gene located within the GLC3A locus on chromosome 2p21 is mutated in individuals with PCG. The triad of epiphora, photophobia, and blepharospasm is classical for PCG. General anesthesia is usually required for an adequate examination of intraocular pressure, corneal diameter, optic disc, and axial length in young children. Congenital glaucoma is almost always managed surgically, with medical therapy being used only as a temporizing measure before surgery or when surgical intervention has repeatedly failed. At least 50% of eyes with PCG presenting at birth will become legally blind (visual acuity < 6/60). Patients with PCG require follow-up examinations throughout their lives.
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PMID:[Primary congenital glaucoma]. 1566 7

In the context of this review, civil unrest is defined as disharmony, expressive dissatisfaction and/or disagreement between members of a community, which leads to a situation of competitive aggression that may find expression as disruption of organisation, conflicts, damage to property and injuries. Such a breakdown of harmonious relationships, which may result in property damage and human injuries that may be threatening to life, varies in magnitude from participation of a very few individuals up to the involvement of large crowds of people, which may evolve into a full-scale riot. It is the latter situation often involving demonstrators, opposing groups and law enforcement personnel that can result in multiple casualties and present a very significant challenge to the resources of local healthcare institutions. The causation of civil unrest incidents is multifactorial and has generic, specific and potentiating elements. With the current national and international societal, political and discriminatory problems, it is likely that civil unrest incidents on both small and large scales will continue to occur at a high and possibly increasing rate on a worldwide basis, and for these not infrequent incidents, the medical community should be in a state of informed preparation. The circumstances of civil unrest incidents are very variable with respect to causation, overall magnitude, frequency, timing, geographical location, numbers of persons involved, demographics of participants, influence of extremists, confrontation with opposing groups and control measures used by law enforcement agencies. Methods used by police and security forces for the control of civil unrest incidents, if advanced negotiations with organisers and verbal warnings have failed, fall basically into two categories: physical and chemical measures. Physical methods include restraint holds, truncheons, batons, mounted horses, projectiles (such as bean bags, plastic and rubber bullets), water cannons, tasers and (rarely) live ammunition. All of these physical measures are associated with pain and immobilisation, and there is a high potential for soft tissue and bone injuries. Some of the more severe physical methods, including plastic and rubber bullets, may cause lethal injuries. The basis for using chemicals in civil unrest incidents is that they cause distraction, transient harassment and incapacitation, temporary impairment of the conduct of coordinated tasks and cause a desire to vacate the area of unrest. Although screening smokes and malodors have sometimes been employed, the major group of chemicals used are peripheral chemosensory irritants (PCSIs), which reversibly interact with sensory nerve receptors in exposed skin and mucosal surfaces, resulting in the production of local uncomfortable sensations and associated reflexes. Major effects are on the eye, respiratory tract and (to a lesser degree) skin. Thus, the induced transient pain and discomfort in the eye, respiratory tract and skin, together with associated lacrimation, blepharospasm, rhinorrhoea, sialorrhoea, cough and breathing difficulties, produce temporary incapacitation and interference with the conduct of coordinated tasks, and form the basis for harassment of malefactors. Currently used peripheral chemosensory irritants are 1-chloroacetophenone, 2-chlorobenzylidene malononitrile, dibenz(b.f)-1,4-oxazepine, oleoresin capsicum and pelargonic acid vanillylamide. Depending on operational circumstances, irritants may be dispersed as a smoke, powder cloud, aerosol, vapour, or in solution; the mode of generation and dispersion of irritant can influence hazard. Brief acute exposure to chemosensory irritants produces effects that generally resolve within an hour, leaving no long-term sequelae. However, sustained exposure to high concentrations may produce tissue injury, notably to the eye, respiratory tract and skin. With solutions of sensory irritants, other formulation constituents may enhance PCSI toxicity or introduce additional local and/or systemic toxicity. By the very circumstances of civil unrest incidents, injuries are inevitable, particularly when emotions are heightened and police and security forces have to resort to various chemical and/or physical means of control. Trauma may include slight to severe physical and/or chemical injuries, psychological problems and occasional deaths. Hospitals should be prepared for a wide range of casualties, and the fact that those seeking help will constitute a heterogeneous group, including wide age range, male, female, and individuals with pre-existing ill health. A major civil unrest incident necessitates that the local receiving hospital should be prepared and equipped for decontamination and triage processes. It is necessary to reassure patients who have been exposed to sensory irritants that the signs and symptoms are rapidly reversible, and do not result in long-term sequelae. With respect to chemical exposures, detailed evaluation should be given to possible ocular, cutaneous, respiratory and gastrointestinal effects. Also, exposure to chemosensory irritants results in transient increases in blood pressure, bradycardia and increased intraocular pressure. This indicates that those with cardiovascular diseases and glaucoma may be at increased risk for the development of complications. This article details the pharmacological, toxicological and clinical effects of chemicals used in civil disturbance control and discusses the management of contaminated individuals. Additionally, the potential for adverse effects from delivery systems and other physical restraint procedures is summarised. Due to the emergency and specialised circumstances and conditions of a civil unrest incident, there is a clear need for advanced planning by healthcare institutions in the event that such an incident occurs in their catchment area. This should include ensuring a good information base, preparations for medical and support staff readiness, and availability of required equipment and medications. Ideally, planning, administration and coordination should be undertaken at both local (regional) and central (governmental) centres. Regional centres should have responsibilities for education, training, ensuring facilities and staffing are appropriate, and that adequate equipment and medicines are available. There should be cooperative interactions and communications with local police and other emergency services. Centrally directed functions should include ensuring adequacy of the information base, coordinating activities and agreeing approaches between the regional centres, and periodic audits of regional centres with respect to the staffing, facility, equipment and training needs. Also, there is a need for most countries to introduce detailed guidelines and formal (regulatory) schemes for the assessment of the safety-in-use of chemicals and the delivery systems that are to be used against heterogeneous human populations for the control of civil unrest incidents. Such regulatory approval schemes should also cover advisory functions for safe use and any required restrictions.
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PMID:Medical management of the traumatic consequences of civil unrest incidents: causation, clinical approaches, needs and advanced planning criteria. 1719 22

While beneficial therapeutically, almost all medications have untoward effects on various body tissues and functions, including the eye in which organ toxic reactions are readily detectable. Every part of the eye and all ocular functions could be affected adversely. In this review, we describe the most commonly recognized drug-induced ocular disorders, their specific clinical features, the medications that can cause the problem, the differential diagnosis and possible mechanisms of action, as well as guidelines for the management of the adverse reactions. The eyelids are most frequently involved in drug toxicity that commonly manifests as inflammation, hypersensitivity reaction or dermatitis. Drug-induced keratoconjunctival disorders present mainly as conjunctival hyperaemia (red eye), with or without superficial corneal involvement. Frequently, drug preservatives in topical ocular medications induce these adverse effects. Treatment of blepharospasm with Botox may lead to drooping of the eyelids and corneal exposure. Intraoperative floppy iris syndrome is a drug-induced reaction in patients treated with tamsulosin and who undergo cataract surgery. Certain sulfa-based drugs can cause swelling of the ciliary body and lead to the development of angle-closure glaucoma. In addition, adrenergic agents, certain beta(2)-adrenergic agonists and anticholinergic agents may induce pupillary dilation and precipitate angle-closure glaucoma in susceptible patients. Glucocorticoids administered systemically, topically or intravitreally are known to increase intraocular pressure, which can lead to the development of open-angle glaucoma in susceptible patients. This painless form of glaucoma has also been associated with the use of the anticancer agents docetaxel and paclitaxel. The toxic effects of systemic and topically applied drugs may manifest as cloudiness of the lens. Long-term use of glucocorticoids produces a characteristic posterior subcapsular cataract and, although the opacities may remain stationary or progress, they rarely regress upon drug withdrawal. Systemic administration of phenothiazines or busulfan induce cataractous changes in the anterior or posterior cortex, respectively. Many systemic drugs reach the retina through the vascular supply. Aminoquinolines induce a characteristic bull's eye maculopathy. Phenothiazines bind to melanin granules and can cause a severe phototoxic retinopathy. Typical tamoxifen retinopathy manifests as crystalline deposits in the inner retina. Some patients treated with retinoids have decreased night vision and abnormal dark-adaptation. Patients on long-term treatment with linezolid may develop an optic neuropathy (swollen or pale optic disc), symmetric painless decrease of visual acuity and colour vision, and bilateral visual field defects. A probable link exists between amiodarone and a bilateral optic neuropathy that is very similar to nonarteritic ischaemic optic neuropathy (NAION). The most common adverse effects of cGMP-specific phosphodiesterase type 5 inhibitors (erectile dysfunction drugs) are changes in colour perception, blurry vision and increased light sensitivity; recently these drugs have been also implicated in the development of NAION. A bilateral, retrobulbar optic neuropathy that manifests as loss of visual acuity or colour vision and visual field defect is associated with the use of ethambutol. Many different kinds of medications can cause similar ocular adverse reactions. Conversely, a single medication may affect more than one ocular structure and cause multiple, clinically recognizable disorders. Clinicians should be mindful of drug-induced ocular disorders, whether or not listed in product package inserts, and, if in doubt, consult with an ophthalmologist.
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PMID:Drug-induced ocular disorders. 1821 89


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