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

Purpose: To evaluate the effectiveness of an augmented Anderson procedure combined with tenotomy and reattachment of the remaining horizontal rectus muscles in correcting horizontal compensatory head posture associated with idiopathic infantile nystagmus.

Methods: Clinical records of five subjects with horizontal compensatory head posture secondary to infantile nystagmus who underwent an augmented Anderson procedure combined with tenotomy and reattachment of the remaining horizontal rectus muscles were retrospectively reviewed. The main outcome measures were angular reduction of head turn, nystagmus reduction, and visual acuity.

Results: The mean preoperative head deviation of 19.6 degrees decreased 79% to a postoperative mean of 4.2 degrees. No patient was overcorrected. Nystagmus was decreased in four of five subjects. Visual acuity improved by one Snellen line or more in three eyes, improved less than one Snellen line in two eyes, and was unchanged in five eyes.

Conclusions: An augmented Anderson procedure combined with tenotomy and reattachment of the remaining horizontal rectus muscles is safe and effective in reducing both abnormal compensatory head posture and nystagmus in idiopathic infantile nystagmus with minimal risk of overcorrection.

In the field of pediatric ophthalmology, assessment of visual acuity is important and necessary in determining treatment plans for children with both functional as well as organic amblyopia, and also to monitor the effect and success of treatment.We shall review the qualitative/subjective tests, as well as the objective/quantitative tests described in the literature for assessing visual acuity, and we shall outline the complexity of vision and its impact on the objective tests.The main purpose of our paper is to present our own scheme of determining visual acuities in infants and pre-literate children, a scheme we believe is simple, effective, implies no extra costs, applicable to infants and young children, and almost infallible in detecting severe amblyopia.

Purpose: To evaluate trypan blue dye in strabismus surgery for tissue identification, to find the lowest optimal concentration, and to describe histological findings. in tissue so stained.

Methods: Trypan Blue dye 0.1% was serially diluted and tested by tissue staining at progressively different concentrations. Fifteen patients were studied using the dye.

Results: Trypan Blue 0.1 percent was the optimal concentration. Muscle, tendon and fibrotic tissues were easily identified and distinguished with the dye at this concentration. Such tissue identification was most useful and enhanced the performance of strabismus surgical operations, and especially in identifying and retrieving slipped or temporarily lost extraocular muscles.Also a thin basement-like membrane surrounding the superior oblique muscle tendons was disclosed with PAS stain, suggesting the presence of glycosaminoglycans.

Conclusions: Trypan Blue 0.1percent contrasts the different tissues, dying the muscle sheath, tendons and fibrotic tissues, but not staining the sclera and muscle fibers per se.

Introduction: The lure of studying the ocular motor system stems from its anatomic and physiological accessibility, ease of measurement and analysis of function, as well as the promise of providing a direct window into the brain. There is an increasing body of knowledge on how the brain responds to peripheral eye muscle manipulation (surgery, medications, denervation, genetic therapy). Investigations in both animals and humans have established that plasticity within the brain occurs after peripheral neuromuscular (medical or surgical) disruption and repair.

Purpose: This paper will review and summarize neurophysiological concepts resulting from recent investigations of the ocular motor system and treatment of involuntary oscillations such as nystagmus.

Methods: Review of both a multidisciplinary literature and the authors 25 years experience evaluating, treating and investigating the ocular motor system.

Conclusions: The ocular motor system in man is a continuously controlled, malleable brain-eye system, which is genetically programmed, environmentally modified and contains powerful reparative processes. It begins during development, extends throughout life and is subject to external manipulation in both health and disease. These ideas challenge the historically significant axiom, i.e., that there is eventual (and a final maturing to an end state) "hard-wiring" of much of both the ocular motor and afferent visual systems. Rather, they now are shown to maintain some degree of plasticity throughout life.