Australian journal of ophthalmology最新文献

Fluorophotometry using the Metricon Model 120 slit-lamp fluorophotometer showed, at an anterior focus, two peaks which corresponded to the cornea and ciliary region--the latter predominantly due to the ciliary body but contributed to by the lens--and following this, at a posterior focus, a mid-vitreous minimum and a chorioretinal peak. Tracings made both before and after fluorescein injection were similar but the levels were higher post-injection, with increasing age and with non-pigmented irides. The change in fluorescein distribution with time after injection is described. Abnormally high fluorescein levels were found in the normal fellow eye in retinal vein occlusion, in diabetes, in senile macular degeneration with neovascular membrane, in active central serious retinopathy and in acute optic neuritis. It is of use in the differentiation of primary choroidal melanoma from naevus and metastases. There was no correlation between isolated measurements of the haemoglobin A1C level and leakage; plasma and ultrafiltrate fluorescein levels in diabetics did not differ from normal.

It is emphasised that isolated Cyclo Vertical Muscle Palsies are more common than is generally realized. Because of this fact they are therefore important. More of these will be uncovered if they are looked for in a sensible manner. A number of conditions can be confused with such a palsy. A differential diagnosis of these conditions is given. A simple and logical method of assessment of such isolated muscle palsies is outlined. Such examination is based on the Parks Three Step Test and the theory behind this has been detailed. Patients each with one of the four possible muscle palsies are discussed. The Management of such conditions is described.

Analysis of the binocular co-ordination errors of a young dyslexic reveals a simple optical explantation for one of two types of letter confusion found in dyslexia. Although binocular control was grossly abnormal in reading, no ocular defect could be found in standard ophthalmic and orthoptic tests. Re-examination of the same patient six years later, again showed no ocular defect on normal testing but binocular movements in reading, while still abnormal, showed no trace of the striking original defect. This complete masking of the original condition with time must severely restrict the value of mass surveys of established dyslexics.

Eighty consecutive patients with amblyopia ex anopsia were treated with the Cambridge Stimulator (Cam). Each patient received an average of six, 15 minute treatment sessions at a frequency of 1-2 per week. Treatment was terminated after two consecutive treatments indicated no change in visual acuity. Sixty-nine patients were given minimal occlusion simultaneously with Cam. treatment. Eleven patients were given full-time conventional occlusion simultaneously with Cam. treatment. Of the first group, 47% achieved 6/12 or better visual acuity, although if the 14 eccentric fixators were excluded, 60% achieved 6/12 or better visual acuity. Of the second group, 91% improved to 6/12 or better vision. This means the patients treated with full-time occlusion and Cam. showed an improvement of visual acuity of nearly twice the extent of those patients with minimal occlusion and Cam. over the same period of time.

The findings in the pattern reversal V.E.C.P.'s have been examined in thirteen (13) patients, with proven or suspected pituitary tumours. Three (3) of these cases have been examined in detail, to highlight the unique capabilities of the pattern reversal V.E.C.P. in the assessment of conduction abnormalities of optic nerve and chiasma, due to compression by pituitary tumours. The V.E.C.P. is shown to be a uniquely sensitive procedure, which yields objective and quantitative data about the functional status of the anterior visual pathways, in cases of suspected compression by pituitary tumours. It is suggested that subclinical optic nerve compression is best detected by serially monitoring optic nerve conduction with the pattern reversal V.E.C.P.