Binocular vision & strabology quarterly, Simms-Romano's最新文献

A 67 year old woman presented with her left eye fixed in adduction and infraduction. She had previous complicated strabismus surgery 18 years ago with a report of intraoperative loss of left medial rectus (MR) muscle (not retrieved at the time of surgery). An Orbital MRI of the left eye showed reattachment of the MR muscle to the globe and an axially enlarged globe associated with inferior displacement of the lateral rectus and nasal displacement of the superior rectus muscles. In ultrasonography the axial lengths were 24.1 mm in the right and 29.9 mm in the left eye. She underwent staged surgery: The first stage was a recession of the left MR muscle and union procedure on the SR and LR muscles followed by a second adjustable suture procedure under topical anesthesia, of right MR recession, right LR resection and left IR recession. After 12 months her eyes were still binocularly aligned. Unilateral high myopia must be considered in progressive esotropia. Imaging and ultrasonography can demonstrate anatomical abnormality and muscle paths to confirm the definite diagnosis. Union procedure described by Yokoyama is an effective procedure in correcting this strabismus associated with high myopia.

Purpose: Distance stereo acuity has been shown to be useful in monitoring conditions such as control of intermittent strabismus. The Frisby Davis distance (FD2) stereotest has been shown to be reliable and is felt to be the gold standard in England. The device however is not widely available in the United States or Canada and is not automated. This study compares the Innova distance stereoacuity test with the Frisby Davis distance (FD2) stereotest.

Methods: Twenty-seven patients with normal acuity and a normal ophthalmology exam were evaluated. Prior to dilation all patients had an Innova distance stereoacuity test and FD2 test. Both the Innova distance stereoacuity test and the FD2 test were performed at ten feet. The results of the tests were compared using Bland-Altman plot analysis.

Results: The INNOVA system tended to underestimate distance stereoacuity by approximately 30 arc seconds compared to the FD2 test. If the INNOVA results were corrected by this amount, then there was a good correlation between the INNOVA results and the FD2.

Conclusion: The Innova distance stereoacuity test underestimates stereopsis by approximately 30 arc seconds but does so with sufficient consistency that it may serve as an acceptable method of measuring distance stereoacuity. This study is the first that has correlated the Innova stereoacuity test with the FD2.

Objective: To present a case of concurrent diagnoses, Retinitis Pigmentosa and Granular Corneal Dystrophy, discovered in one patient experiencing progressive vision loss.

Methods: In this case report we studied fundus photographs, anterior segment photographs, Goldman visual field, and electroretinography.

Results: Exam findings on presentation: A 58-year-old Korean female with bilateral crumb-like corneal stromal deposits, waxy pallor of the disc, attenuated vessels and bone spicules. Visual field deficit, ERG and clinical evaluation supports a final diagnosis of both Retinitis Pigmentosa and Granular Corneal Dystrophy.

Conclusion: The presentation of both Retinitis Pigmentosa and Granular Corneal Dystrophy is a rare combination of vision loss. While both conditions are autosomal dominant and thus not, per se, extremely rare, they have not been documented to both contribute to vision loss in one patient.

Medical Specialties such as Ophthalmology extend historically back to the beginning of recorded history. Before there was photography to record physical abnormalities of living creatures, there was art and artists who did the recording in their works. Fortunately, many such recordings have been preserved, usually in museums. They provide the graphic evidence of the same medical problems which our ancestors suffered and survived but which we still do but now understand and can ameliorate better. The purpose of this paper is to provide and study several more examples of these art works, to illuminate these historical aspects of medicine, ophthalmology and binocular vision and life.