Optometry最新文献

Background: Neovascularization can occur in various ocular structures including the retina, iris, anterior chamber angle and cornea; however, it rarely occurs in the crystalline lens. Neovascularization results secondary to hypoxic conditions within the eye. A natural balance of angiogenic and antiangiogenic factors are critical for the eye to prevent the formation of neovascularization. Various factors can upset this natural balance, resulting in angiogenesis. Due to the lack of an intrinsic blood supply, intralenticular neovascularization is rare.

Case report: A 61-year-old black male presented with a previous diagnosis of proliferative diabetic retinopathy (PDR). His ocular history included cataract extraction in the left eye (OS) and tractional retinal detachment in both eyes that was surgically repaired OS. His entering visual acuities were NLP OD and 20/400 OS. Upon biomicroscopic evaluation OD, there was evidence of a hypermature cataract with iris neovascularization and neovascularization coursing over and within the anterior capsule of the lens.

Conclusions: Intralenticular neovascularization is a rarely reported ocular complication. We present a patient with uncontrolled diabetes resulting in proliferative diabetic retinopathy, extreme ocular ischemia, and consequent intralenticular neovascularization.

Background: Lipemia retinalis is a well-documented but rate ocular finding directly associated with serum triglyceride levels. The clinical presentation varies with the amount of triglycerides in the blood and completely resolves with lowering triglyceride levels, making this condition transient with no visual symptoms;

Case report: A 46-year old white man presented with lipemia retinalis and, hours later, to the Emergency department with acute pancreatitis secondary to hypertriglyceridemia;

Conclusion: Lipemia retinalis warrants an immediate complete blood count and lipid panel to Determine triglyceride levels with referral to a primary care provider.

Background: Dry eye syndrome (DES) has been described by The International Dry Eye WorkShop as ''multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance and tear instability with potential damage to the ocular surface.'' Inflammation has been recognized as a primary contributor to the disease and was a tremendous step forward in the description and treatment of DES. Although most treatments of DES treat inflammation, the signs and symptoms of DES usually return shortly after discontinuing the use of the anti-inflammatory agent;

Case: We present a case of a 70-year-old patient who presents with significant dry eye symptoms for 2 years. She reports the need to wear sunglasses during all waking hours, both indoors and out, and had discontinued her hobby of gardening. She had ocular rosacea diagnosed at a previous ophthalmology practice and did not respond to any past treatments. The patient was treated with 25% platelet-rich plasma (PRP) and experienced significant improvement and a return to a normal quality of life that has continued for more than a year after discontinuing treatment;

Conclusion: Our group is investigating the use of biologic therapeutics in the treatment of various forms of DES. We suggest that a clinically acceptable dosage of PRP provides the ocular surface with the components necessary to restore normal cellular tensegrity and provides a foundation to eliminate the recurrence of the inflammation associated with DES.

Background: The visual system is necessary for reading. Understanding the mechanics of eye movements during reading can give insight into the reading process. The ReadAlyzer is an electronic recording system that measures eye movements while reading. Long passages on the ReadAlyzer of 800 words have recently been introduced as a tool to assess the efficiency of reading eye movements. Previously, short passages of 100 words have been used exclusively. This project was designed to determine if passage length influences the quality of reading eye movements;

Methods: Optometry students (N = 40) at Southern College of Optometry were separated into 2 equal groups (symptomatic vs. asymptomatic) based on the College of Optometrists in Vision Development Quality of Life questionnaire score. Each subject then performed two reading passage recordings with the ReadAlyzer: one short, one long. The order of the passages was alternated to reduce fatigue effects. Data were collected based on the ratio of fixations-to-regressions;

Results: A multivariate analysis of variance indicated that the difference between short and long paragraphs for the symptomatic and asymptomatic groups combined was significant (P = 0.001) but was not significant for the symptomatic group vs. the asymptomatic group ( P = 0. 651) . Post-hoc comparisons using estimated marginal means indicated for asymptomatic, short vs. long, P = .036 and for symptomatic, short vs. long, P = 0.008. Additionally, for short length, symptomatic vs. asymptomatic, P = 0.242 and for long length, symptomatic vs. asymptomatic, P = 0.176;

Conclusion: This information indicates that both symptomatic and asymptomatic patients will have more difficulty on longer reading passages. This finding calls into question the use of shorter length reading tests to determine a diagnosis of ocular motor dysfunction and other visual efficiency problems.

Background: Chiari I malformation (CM1) is the caudal herniation of the cerebellar tonsils into the foramen magnum. It can cause several neurological signs and symptoms, or be asymptomatic. Papilledema is a potential, but unusual, manifestation of CM1. While CM1 is often asymptomatic, papilledema is less likely to be. We present the first reported case of a progressive, asymptomatic papilledema as the sole presenting sign of a CM1;

Case report: A 39 year old woman presented without neurological symptoms and was found to have optic disc edema. Humphrey visual fields were normal and B-scan showed no drusen. On a subsequent visit, optical coherence tomography showed advanced disc edema. Neuroimaging revealed a CM1. The patient was referred for neurological consultation for the management of the papilledema secondary to CM1;

Conclusions: This case represents the importance of a thorough ocular examination, as the patient's asymptomatic neurologic condition would not have been diagnosed without the discovery of the papilledema.