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Biomedical subjects

C D Witherspoon

Publications and source records attributed to C D Witherspoon.

At least 19 recordsLinked to original sources
PubMed2004

The Birmingham Eye Trauma Terminology system (BETT).

PURPOSE: To evaluate the international eye injury scene and design a standardized terminology for mechanical eye injuries. METHODS: Surveys of practicing ophthalmologists and an extensive review of the international ocular trauma literature. Development of the Birmingham Trauma Terminology (BETT) using a logic-based approach. RESULTS: BETT always uses the entire globe as the tissue of reference. Its well-defined terms encompass all types of mechanical eye injury. A one-to-one relationship exists between terms and clinical conditions. CONCLUSION: BETT provides an unambiguous, consistent, simple, and comprehensive system to describe any type of mechanical globe trauma. Endorsed by several societies and peer-reviewed journals as the standardized international language of ocular traumatology, BETT is expected to become the preferred terminology for categorizing eye injuries in daily clinical practice.

Eye Injuries↗
PubMed2000

The epidemiology of serious eye injuries from the United States Eye Injury Registry.

BACKGROUND: Trauma remains a major problem throughout the world. The prognosis of severe eye injuries is commonly bleak. This paper focuses on the epidemiology of eye trauma, the role of ocular epidemiology, and identification and reduction of risk factors. METHODS: An analysis of the first 8,952 patients reported with severe eye injuries, defined as those eye injuries resulting in permanent and significant (measurable and observable on routine eye examination) structural and/or functional changes to the eye, from the United States Eye Injury Registry as of 31 July 1998. RESULTS: The age of patients entered was from the 1st year of life to 103 years. Fifty-eight percent of those injured were less than 30 years of age. The male to female ratio was 4.6:1, reaching 7.4:1 in the fourth decade of life. Almost half of the injuries involved the retina, and 77% of the injured eyes required one or more surgical procedures, including a large proportion which have undergone vitreoretinal surgical procedures. CONCLUSION: Injuries remain the most serious public health problem facing developed nations. Yet, a persistent inadequacy exists both in the standardized documentation of eye injuries and in their treatment. With appropriate surgical and medical intervention, a majority of the reported injured eyes recovered functional levels of visual acuity. It appears that glasses, including prescription glasses and even non-prescription sunglasses, can offer measurable protection which results in a lower incidence of severe eye injuries to those wearing glasses.

Adolescent↗
PubMed1998

Terson syndrome. Results of vitrectomy and the significance of vitreous hemorrhage in patients with subarachnoid hemorrhage.

OBJECTIVE: The purpose of study A was to assess the effectiveness of vitrectomy for Terson syndrome. The purpose of study B was to determine the incidence and significance of vitreous hemorrhage in patients with subarachnoid hemorrhage. DESIGN: Study A is a retrospective review of case series. Study B is a prospective study. PARTICIPANTS: Study A examined a consecutive series of 4 children (7 eyes) and 23 adults (26 eyes). Study B examined a consecutive series of 100 patients. INTERVENTION: Subjects in study A underwent pars plana vitrectomy for dense vitreous hemorrhage following intracranial hemorrhage. In study B, ophthalmoscopic examination of patients undergoing neurosurgery for ruptured cerebral aneurysms was used. MAIN OUTCOME MEASURES: In study A, the extent and rapidity of visual recovery and intraoperative and postoperative complications were examined. In study B, the incidences of intraocular hemorrhage and Terson syndrome in the cohort and the significance of the presence of vitreous hemorrhage in patients with subarachnoid hemorrhage were examined. RESULTS: Study A: There was substantial and rapid visual improvement in 25 of the 26 eyes (96%) of the adult patients, with 21 eyes (81%) achieving > or = 20/30 final visual acuity. Only limited improvement was achieved in children's eyes (< or = 20/60). Study B: Intraocular hemorrhage was found in 17% of eyes in patients with subarachnoid hemorrhage; the incidence of Terson syndrome was 8%. All patients with Terson syndrome and 89% of the patients with other types of intraocular hemorrhage had a history of coma compared with 46% of those without intraocular hemorrhage (P = 0.0003). CONCLUSIONS: Vitreous hemorrhage in patients surviving subarachnoid hemorrhage appears to be more common than previously thought, underscoring the need for routine funduscopic screening. Surgical intervention is highly effective in hastening visual rehabilitation of adults with Terson syndrome. The less encouraging results in infants may be due to amblyopia or direct brain damage caused by the cerebrovascular incident.

Adult↗
PubMed1996

A standardized classification of ocular trauma.

BACKGROUND: No internationally standardized classification of ocular trauma terminology has existed heretofore. Despite a growing interest in eye injuries, the absence of a common language continues to impede both clinical care and research. METHODS: A classification was initially developed based on the authors' extensive personal experience. It then under-went repeated reviews over a 3-year period by international ophthalmic specialists. Written and oral suggestions from respondents in 19 countries and from selected ocular trauma experts were considered and incorporated. RESULTS: By always using the entire globe as the tissue of reference, the new classification is unambiguous, consistent, simple, and comprehensive. It provides definitions for the terms commonly used in eye trauma and creates a logical system of injury types. CONCLUSION: In addition to widespread international acceptance by professionals, the new classification has been endorsed by the International Society of Ocular Trauma, the United States Eye Injury Registry, the American Academy of Ophthalmology, the Hungarian Eye injury Registry, the Vetreous Society, and the Retina Society. It can be reasonably expected that the system will ultimately become the standardized international language of ocular trauma.

Eye Injuries↗
PubMed1996

A standardized classification of ocular trauma.

BACKGROUND: No internationally standardized classification of ocular trauma terminology has existed previously. Despite a growing interest in eye injuries, the absence of a common language continues to impede both clinical care and research. METHODS: A classification has been developed initially based on the authors' extensive personal experience. It then has undergone repeated reviews over a 3-year period by international ophthalmic audiences, incorporating suggestions from respondents in 13 countries and selected ocular trauma experts. RESULTS: By always using the entire globe as the tissue of reference, the new classification is unambiguous, consistent, and simple. It provides definitions for the commonly used eye trauma terms within the framework of a comprehensive system. CONCLUSION: The new classification has been endorse by the Board of Directors of the International Society of Ocular Trauma, the United States Eye Injury Registry, the Hungarian Eye Injury Registry, the Vitreous Society, the Retina Society, and the American Academy of Ophthalmology. It can be reasonable expected that the system eventually will become the standardized international language of ocular trauma. The authors urge ophthalmologists to begin using this terminology in both clinical practice and research.

Eye Injuries↗
PubMed1995

Eye injury and the air bag.

Although traffic-related mortality and morbidity figures have improved in recent years in the United States, motor vehicle crash remains a leading source of death and injury, requiring additional efforts to reduce its toll. The rationale for equipping passenger vehicles with air bags was to introduce a mechanical cushion between occupants and the car's hard interior surfaces. Although air bags have proven to be effective in saving lives and preventing injuries, a growing number of reports indicate that the air bag is also a potential source of ocular trauma. This article analyzes 24 eye injuries alleged to be air bag-related. The posterior segment was injured in less than half of cases, and only one eye sustained severe visual impairment. Although such reports may help to improve air bag design, the air bag should remain "innocent until proven guilty." We report that in motor vehicle crashes, the rate of ocular trauma increases 2.5 times if the car is not air bag-equipped. In contrast to injuries seen in vehicles without air bags, eye trauma sustained in vehicles with air bags is typically closed globe.

Accidents, Traffic↗
PubMed1995

Percentage scattergram to depict changes in large amounts of data over time.

Graphical representation of changes in epidemiologic or clinical parameters over time is difficult when a large amount of data is involved. The traditional methods either cannot incorporate all necessary information (bar graphs, pie charts, tables) or are unable to depict information on more than a limited number of individuals (scattergrams). We have designed an effective way of visual presentation of the changes a variable demonstrates over time. The percentage scattergram provides accurate and complete depiction of any number of data points, allowing comprehensive and rapid analysis.

Data Display↗
PubMed1994

Epidemiology of motor vehicle crash-related serious eye injuries.

The Eye Injury Registry of Alabama has been collecting epidemiologic, treatment, final outcome, and rehabilitation information on serious ocular trauma since 1982. By December 31, 1989, 150 motor vehicle crash-related eye injuries had been registered. This is the largest series of motor vehicle crash-related serious eye injuries reported. The mean age of those injured was 29 years; 61% were between 16 and 35 years of age, and 73% were males. Ten individuals (7%) suffered bilateral eye injuries. The retina was injured in 47% of eyes. The initial visual acuity was 19/200 or worse (legal blindness) in 47% of eyes. Of eyes with at least 3 months of follow-up, 63% had worse than 20/200 initial visual acuity and 41% remained legally blind. Twelve percent of eyes required removal. Possibly due to the large number of blunt ruptures, motor vehicle crash-related eye trauma carries a particularly unfavorable treatment prognosis. Prevention of these injuries is therefore of extraordinary importance.

Accidents, Traffic↗
PubMed1992

Collagen gel contraction by cells associated with proliferative vitreoretinopathy.

The capacities of porcine choroidal fibroblasts, retinal glial cells, and retinal pigment epithelial cells to contract collagen gels in vitro were compared. Experiments with varied cell numbers indicated that glial cells are the most effective, followed by choroidal fibroblasts and retinal pigment epithelial cells. Analysis of the secretory products from cultures of these cell types revealed that retinal pigment epithelial cells synthesize and secrete peptides that promote fibroblast contraction of collagen gels in vitro. The mechanism of action of the retinal pigment epithelial cell-secreted contraction promoter was compared with that found in serum (type A) and secreted by cultured endothelial cells (type B). Like the serum factor, the retinal pigment epithelial cell-secreted factor was not dependent on active protein synthesis by the target cell and must be present continuously to promote contraction.

Animals↗