Cases reported "Hyperopia"

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1/5. Optometric management of optically induced consecutive exotropia.

    A 5-1/2 year old black female initially presenting with a moderate angle esotropia and latent hyperopia developed a large angle constant exotropia 2 years after final correction of her refractive error. The occurrence of consecutive exotropia as a result of optical correction of hyperopia has been documented infrequently in the ophthalmologic literature and has rarely been mentioned in the optometric literature. While the overall risk for occurrence of this complication from correction of hyperopia may be small, it is a problem which may occur and can be avoided. Unfortunately, there is only limited information about the various risk factors that should be monitored to avoid the occurrence of an optically induced consecutive exotropia. What is available with regard to evaluation and management is scant, and there are no case reports emphasizing optometric management which includes the use of lenses, occlusion and vision therapy. The purpose of this paper is to present a case report of optically induced consecutive exotropia followed by a summary of the available information from the optometric and ophthalmologic literature. This combined information will aid optometrists managing these patients to avoid the occurrence of this problem and better understand the various management aspects when it does occur.
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2/5. amblyopia: a multidisciplinary approach. Proctor lecture.

    Clinically different forms of amblyopia share as common denominators an inability to form well-defined and focused images in one or both eyes and, in the case of unilateral amblyopia, unequal visual input to the brain. This suggests two amblyopiogenic mechanisms which are effective, individually or in unison, in the various forms of amblyopia. The first is lack of adequate visual stimulation during infancy, causing visual deprivation. The second mechanism is based on abnormal binocular interaction. The clinical evidence and data from the animal laboratory will be reviewed in support of this dual etiological concept of amblyopia. An etiological classification of amblyopia suggested in 1972 on hypothetical grounds can be upheld on the basis of information that has accumulated since that time. amblyopia is not a static condition but has a strong dynamic component since its severity can be modified by the type of stimulation received by the sound eye. Special emphases is placed in this lecture on this unique feature which is based on binocular interaction and is similar to the inhibition of afferent visual stimulation during suppression.
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3/5. About a particular interaction of the fixating eye in strabismic amblyopia after treatment.

    2 cases of strabismic amblyopia which were successfully treated are examined. Later on, a slight myopia appeared in the fixating eye only, while the amblyopic eye remained practically emmetropic. The 2 patients had to wear monocular myopic correction, otherwise the visual acuity of the other eye would have been reduced below the visus (without correction) of the fixating but myopic eye. A third case was reported of a hypermetropic patient with a right amblyopic eye and a left fixating but myopic eye. After the appearance of myopic lesions in the dominating eye, pleoptical treatment was successfully given to the amblyopic eye, so that in the end it turned out better than the other eye. Also, in this case the patient was quite disturbed for a long time due to the interference of the eye which was originally better. The authors underline the importance of these interocular effects, both from the standpoint of practical and medical information.
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4/5. stellate ganglion block alleviates pseudo-obstruction symptoms followed by episodes of hypermetropia: case report.

    BACKGROUND AND OBJECTIVEs: The chronic intestinal pseudo-obstruction due to visceral myopathy is a disorder resembling bowel obstruction but without mechanical occlusion. Frequently, parenteral nutrition becomes the final palliative treatment. A patient affected with this syndrome for 16 years was suffering causalgic pain provoked by intraveneous perfusion. stellate ganglion block was requested in the hope of maintaining the perfusion. methods: stellate ganglion block not only stopped the pain but unexpectedly, it temporarily relieved the pseudo-obstruction symptoms. Two radiofrequency coagulations in the stellate ganglion prolonged the beneficial effects on gastrointestinal transit for more than 3 weeks, after which the symptoms returned. Multidisciplinary and multicenter advice was that further destructive treatments not be attempted. RESULTS: Repetitive stellate ganglion blocks with 2 mL of bupivacaine 0.75% restored gastrointestinal function for more than 3 weeks. However, after performance of radiofrequency coagulation, infiltration with bupivacaine was followed by hypermetropia on the right eye of 2 weeks duration. CONCLUSIONS: The relationship between stellate ganglion block and gastrointestinal function has not been described. This case report does not provide sufficient information to recommend this technique for pseudo-obstruction symptoms. Moreover, the result in this case is a fortuitous observation, lacking a clear scientific explanation. Further study may be warranted.
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5/5. Ocular abnormalities in a patient with partial deletion of chromosome 6p. A case report.

    We report on a patient with a de-novo deletion of chromosome 6p. This male infant presented with multiple systemic congenital defects together with an unusual ocular phenotype. Slit-lamp examination revealed thin, opaque, rectilinear bands within the anterior segment partially connecting iris to corneal endothelium. These were associated with bilateral hyperopia and optic nerve hypoplasia. Ocular abnormalities in such patients have been documented although the number of individuals is small and identical cytogenetic defects are rarely encountered. We compare the clinical findings in this case with previously described phenotypes. Characterisation of such cases is important as it is becoming apparent that deletion of genetic information encoded on chromosome 6p has implications for ocular embryogenesis.
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