China
Africa
Explore chapters and articles related to this topic
Special Considerations in Gaze
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
An in-depth knowledge about basic neuro-physiological principles of gaze and the impact of the cerebellum and basal ganglia on these networks can help in understanding the different gaze-holding mechanisms. This may pave the way to further research aiding in developing the gaze mechanisms as clinical biomarkers of various neurological diseases.
Ophthalmic Injuries
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
Ocular motility should be examined, looking especially for restriction of eye movement in any direction. The presence of diplopia (double vision), either in the primary position or gaze evoked, is a useful symptom, but it should be remembered that not all people have binocular vision (for example, those with a history of squint or a lazy eye) and eye injury causing loss of vision may prevent binocular diplopia. The presence of double vision on upward gaze or downward gaze and loss of sensation in the area of the infraorbital nerve point to an orbital floor fracture with involvement of the inferior rectus muscle and infraorbital nerve. In some cases, a degree of neurological trauma may also accompany orbital injuries, and the possibility of higher-level disruption of ocular motility, for example, from cranial neuropathies or brain stem damage, should also be considered. Any ocular motility findings should be taken in the context of the broader picture and correlated with other clinical findings.
Patient–Professional Communication
Published in Richard J. Holden, Rupa S. Valdez, The Patient Factor, 2021
Onur Asan, Bradley H. Crotty, Avishek Choudhury
Eye gaze has been reported as the most powerful component of nonverbal communication (Henry et al., 2012) and an important aspect of patient-centered communication (Gorawara-Bhat & Cook, 2011). Eye gaze is also used to understand the extent to which patients feel cared for by clinicians (Rose et al., 2014). Gaze provides an objective and measurable indication of attention and communication and can be an attribute that informs design guidelines (Asan, Tyszka, et al., 2018; Asan et al., 2015). Many studies have used eye gaze as a factor to quantitatively measure clinician–patient communication (Asan, Tyszka, et al., 2018; Asan et al., 2015; Gorawara-Bhat & Cook, 2011; Gorawara-Bhat et al., 2013; Montague & Asan, 2014; Ruusuvuori, 2001). The measurement of eye gaze, through video analysis, has been used and validated by previous studies (Asan et al., 2014; Asan & Montague, 2012; Montague & Asan, 2014) as a method to measure nonverbal communication between patient and physicians.
Videonystagmography (VNG) and video head impulse test (vHIT) analysis of patients with migraine who had first episode of vertigo
Published in Hearing, Balance and Communication, 2023
The headache could be absent during acute attacks and the spontaneous course of vertigo symptoms could be a diagnostic problem in clinical practice and it is generally dependent on the exclusion of other causes [15,16]. We have noted this complex characteristic of migraine. Twenty-four patients (70.5%) did not have any nystagmus in any primary gaze position. Three patients had gaze- evoked nystagmus. Vertical type spontaneous nystagmus was not noted in any patients. Fourteen out of 24 patients who had no spontaneous nystagmus had positional nystagmus which may present a diagnostic and therapeutic challenge. This is an interesting and remarkable finding which should be considered in the evaluation of those patients. It has been reported that positional or head-induced type of vertigo in migraine can be identified by only the lack of temporal characteristics of benign paroxysmal positional vertigo [11,16]. Von Brevern et al. suggest that positionally-induced migrainous vertigo results from dysfunction of inhibitory fibres from the vestibulocerebellar nodulus and uvula to the vestibular nuclei [17]. Distinguishing vestibular problems associated with migraine from other common disorders like BPPV, Meniere’s disease, vestibular neuritis, etc. is crucial since vestibular symptoms may resolve with anti-migraine drugs [16].
Two-muscle surgical treatment of a compensatory head tilt in an adult with acquired downbeat nystagmus
Published in Baylor University Medical Center Proceedings, 2023
Daniel Vinson, Jonathan Kopel, Caezaan Keshvani, James Lee, Kenn Freedman
Nystagmus in children and adults is an involuntary oscillatory eye movement disorder that can vary in intensity in different gaze positions. If there is a certain gaze position where the nystagmus is least active, this is known as a null point (or zone), and often the patients’ symptoms and vision improve when the eyes are deviated toward that null point/zone. Patients with an eccentric null point/zone will often assume a compensatory head tilt to set their eyes in that null zone and optimize their vision. This forms the basis of the Kestenbaum-Anderson–like operations, which have proven beneficial in treatment of compensatory head tilt in patients with infantile nystagmus. The Kestenbaum-Anderson procedures involve shifting the eyes in the direction of the abnormal head turn/tilt and away from the preferred direction of gaze. The Kestenbaum procedure involves bilateral recession of the yoke muscles opposite to the head turn, combined with bilateral resection of their antagonists. Anderson’s procedure only involves recession of the yoke muscles. However, the procedure’s use in acquired vertical nystagmus in adults with head tilt has rarely been reported.
Prevalence of Masked versus Unmasked Blepharoptosis in Subjects Seeking for Blepharoplasty and or Eyebrow Lift
Published in Seminars in Ophthalmology, 2022
Parya Abdolalizadeh, Mohsen Bahmani Kashkouli, Meysam Maleki, Nasser Karimi, Soheyla Jafarpour, Fatemeh Zarastvand
While all the subjects with unmasked ptosis presented with a decreased MRD1 (direct sign of ptosis), a majority of subjects with masked ptosis (82%) presented with indirect signs of ptosis. This could be attributed to a significantly less severe ptosis in the masked group (Table 2). Compensatory frontalis muscle contraction raises the upper eyelid and leads to indirect signs of ptosis (Figure 1) in some of the subjects.15 Neutralization of this compensatory contraction is required to reveal the real MRD-1. To senior authors, dynamic comparison of two upper eyelid levels at many points from down to primary gaze (Figure 2) is very helpful for revealing the presence of a unilateral mild ptosis. Such a maneuver unintentionally relaxes the frontalis muscle contraction and unmasks the unilateral mild ptosis (Supplement Digital Content 1, film, it compares upper eyelid levels in 3 subjects at different points from down to primary gaze in order to reveal the ptosis).