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An Approach to Oculomotor Anomalies in a Child
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
A full ophthalmic examination including assessment of the pupils, anterior segment, and posterior segment is also crucial. Dilated fundus examination can also be used to evaluate for fundus torsion. Lastly, cycloplegic refraction should be performed in all children to aid in the final diagnosis and management.
Telemedicine in Ophthalmology
Published in Ching-Yu Cheng, Tien Yin Wong, Ophthalmic Epidemiology, 2022
Jane Scheetz, Samantha Simkin, Zachary Tan, Shuan Dai, Mingguang He
Despite growing evidence of the effectiveness of routine assessment and early intervention, compliance with DR examination guidelines is suboptimal, with reports suggesting that less than 50% of diabetics have routine eye checks (14, 21). Screening using teleophthalmology offers great potential to improve access and quality of care to those with diabetes; however, programs should be planned and deployed in a safe and effective way. There must be guidelines and protocols in place to determine whether standards of care are being met. Whilst the assessment of high-quality retinal photographs by trained professionals is effective in identifying most clinically significant DR, a validated teleophthalmology DR screening is not a substitute for a comprehensive dilated fundus examination by an ophthalmologist or experienced optometrist.
Wavy Lines, Distorted Vision and Blur
Published in Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen, Practical Emergency Ophthalmology Handbook, 2019
Anterior segment assessment: Any anterior segment disease has the potential of causing blurry vision. They are usually associated with other symptoms like redness, pain or photophobia. Patients with severe dry eyes or eyes that water excessively can both cause blurry vision. Painless blurry vision or reduced vision always requires a dilated fundus examination. If your patient describes intermittent blurry vision, assess their anterior chamber depth and perform gonioscopy prior to dilating, to rule out intermittent angle closure. A subluxed natural lens or de-centred intraocular lens (IOL) implant can cause a shift in focus and blurry vision. If an IOL is significantly de-centred, or the patient's pupils dilated, the edge of the lens would diffract light and cause distortion or an arc of light is seen in the peripheral vision. Detailed examination is required to see if the lens is still stable.
An Atypical Case of Enterovirus Meningitis Presenting with Unilateral Optic Disc Swelling and Minimal Optical Symptoms
Published in Ocular Immunology and Inflammation, 2023
Efthymios Karmiris, Georgios Vasilakos, Konstantinos Tsiripidis, Evangelia Chalkiadaki
On examination, his best corrected visual acuity was 20/20 in both eyes. Full color vision on Ishihara testing was noted and no red desaturation was detected for both eyes. Pupils were round, reactive to light, with an elicited relative afferent pupillary defect in his LE. No proptosis, painful eye movements or ocular motility restriction was noted. Intraocular pressure was 15 mmHg for the right and 17 mmHg for the left eye. Anterior segment was normal in both eyes and dilated fundus examination revealed a clearly swollen left optic disc and a normal optic disc in the right eye (RE). The rest of the dilated fundus examination was normal in both eyes without vessel enlargement, retinal hemorrhages or macular exudates. The macula and the peripheral retina were flat and intact in both eyes.
Functional imaging of mitochondria in genetically confirmed retinal dystrophies using flavoprotein fluorescence
Published in Ophthalmic Genetics, 2022
Matthew W. Russell, Justin C. Muste, Kanika Seth, Madhukar Kumar, Collin A. Rich, Rishi P. Singh, Elias I. Traboulsi
The OcuMet Beacon® third-generation device (for investigational use only) was used for FPF imaging (14–16). Patients provided written informed consent prior to study participation. Each eye was imaged three times, 5–10 minutes after dilated fundus examination. Raw images generated by the device were securely exported to OcuSciences®, developers of the OcuMet Beacon®; for quality control to ensure proper focus, centering around the fovea, and exclusion of shadow artifacts (e.g, eyelid or eyelash). Only the highest quality of the three images taken per eye was used for analysis. Eyes with no good quality images were excluded from the cohort, which occurred in 4 out of the 125 dystrophy eyes (3.2%). Control eyes were age matched from a database of 552 eyes. Proprietary software was used to calculate FPF parameters for each image. FPF intensity was calculated as the average FPF intensity over a 5.5 mm diameter region centered around the Fovea. FPF heterogeneity was calculated as the integral of the peak areas of FPF intensity in the region of interest, yielding a measure of variability.
The Vascular Pattern In Vicinity Of Chorioretinal Coloboma: An Optical Coherence Tomography Angiography Study
Published in Ophthalmic Genetics, 2022
Fatemeh Abdi, Parya Abdolalizadeh, Mahsa Sardarinia, Arzhang Gordiz, Fatemeh Zarastvand, Sara Hemmati, Raziyeh Mahmoudzadeh
In this observational study, patients with known chorioretinal coloboma presenting to an ophthalmology clinic at a university-based hospital from March 2018 to October 2019 were enrolled. This study adhered to the tenets of the Declaration of Helsinki, and informed consent was obtained from study subjects. Each patient underwent a comprehensive ocular examination, including best-corrected visual acuity, slit-lamp examination, and indirect ophthalmoscopy for dilated fundus examination. The extension of the coloboma toward the disc and macula was noted and categorized by Gopal classification (11) in which eyes with choroidal coloboma are divided into six classes based on disc involvement and appearance. In type 1, the normal optic disc is far away from the choroidal coloboma. Type 2 has abnormal disc (but not colobomatous disc), far away from choroidal coloboma. Type 3 involves the colobomatous disc that is far away from choroidal coloboma. Choroidal coloboma involves the normal optic disc in type 4, colobomatous disc in type 5, and hardly recognizable disc in type 6.