Thyroid eye disease: an unusual presentation.
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Adult↗
Biomedical subjects
C P Noonan
Publications and source records attributed to C P Noonan.
Validation of a handheld automated keratometer in adults.
PURPOSE: To evaluate the Nidek handheld automated keratometer and compare it with the manual Zeiss keratometer. SETTING: St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom. METHODS: Forty-five normal adult volunteers were included in the study. Three sets of randomized keratometry measurements were taken from both eyes of each adult, with both instruments by two independent observers. Readings included powers of the steep and flat meridians and axis of the flat meridian. The mean difference between the two instruments was calculated. The variance of each instrument was calculated for the axis, the steep and flat meridians, and the mean of the two meridians. RESULTS: There was no significant difference between the mean Nidek and Zeiss keratometry readings for the steep (0.015 mm; P = .167) or flat (0.054 mm; P = .069) meridian or axis measurements (P = .172). On repeated measurements, the within-subject and within-group variabilities, calculated separately for each instrument, were significantly less for the Nidek automated keratometer than the Zeiss keratometer (P < .01) when measuring the steep and flat meridians. There was however, a significant increase in axis variability using the Nidek keratometer (range 20 degrees; P < .01). CONCLUSION: The Nidek automated keratometer was accurate, reliable, and easy to use and compared favorably with the manual Zeiss keratometer when measuring corneal curvature. In the handheld mode, the Nidek is not suitable for axis measurements. It has the additional advantage of portability.
Adult↗
Repeatability of the hand-held Nidek auto-keratometer in children.
Measurement of the anterior corneal radius of curvature is important in the pediatric population for proper fitting of contact lenses, calculation of intraocular lens power in patients undergoing cataract surgery, and monitoring changes in shape of the cornea in keratoconus. Because astigmatism in preschool children is mainly the result of corneal asphericity, measurement of the anterior corneal radius of curvature may also be used in screening in children at risk for amblyopia. The aim of this study was to determine the repeatability of the hand-held automated Nidek keratometer (Nidek Co. Ltd, Tokyo, Japan) and its ease of use in children.
Adolescent↗
Management of Irish patients with intraocular melanoma referred to Liverpool, England.
PURPOSE: This study reviews the results of patients referred from Ireland for treatment of an intraocular melanoma at the Ocular Oncology Service at St Paul's Eye Unit, Liverpool. PATIENTS AND METHODS: There were 57 patients with a median age of 55 years. Management included plaque radiotherapy (14), proton beam radiotherapy (17), local resection (10), endoresection (6), and enucleation (10). Fifty-two tumours involved the choroid. The tumours had a mean diameter of 11.4 mm and a mean thickness of 5.2 mm. RESULTS: The follow-up period had a median of 267 days. Retention of the eye was achieved in all 47 cases who underwent conservative management. Ninety percent of patients retained a vision of counting fingers, with an acuity of 6/12 or better in 50%. CONCLUSION: This group of patients gives an indication of the results that can be expected when uveal melanoma is managed by a variety of conservative techniques in a specialised ocular oncology service.
Brachytherapy↗
Acute serous detachment with argon laser photocoagulation in retinopathy of prematurity.
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Acute Disease↗
Trends in the management of stage 3 retinopathy of prematurity.
AIMS/BACKGROUND: The clinical outcome of 66 consecutive infants with stage 3 retinopathy of prematurity (ROP) is reported. METHODS: Thirty four infants (64 eyes) were treated with cryotherapy and 32 infants (59 eyes) underwent laser photocoagulation. RESULTS: Infants with anterior-mid zone II ROP had a high rate of disease regression whether treated by cryotherapy or laser photocoagulation. Infants with posterior zone II or zone I ROP had a 40% success rate with cryotherapy, and 87.5% when treated with laser photocoagulation. CONCLUSION: Evolving experience and changing management policies in infants with posterior ROP has led to improved results.
Cryotherapy↗
Greater severity of clinical features in older patients with Duane's retraction syndrome.
Duane's retraction syndrome (DRS) is a well-described entity. However, the possibility of this condition having progressive features has not been previously documented. We studied 21 consecutive patients with this disorder and found that the incidence of severe retraction on adduction, the occurrence of enophthalmos in the primary position and the presence of upshoots and downshoots were significantly higher in adults with type I DRS than in children. Awareness that the clinical features may increase in severity is important as parental counselling, coupled with effective communication to general practitioners, can prompt re-referral should such problems arise. Surgical intervention as a consequence, becomes an available option to correct disease progression.
Adolescent↗
Surgical management of third nerve palsy.
AIMS: A surgical technique has been developed in order to obtain ocular alignment in the primary position in patients with third nerve palsy. METHODS: A method for surgically correcting the vertical deviation and the pseudoptosis is described in three patients with longstanding third nerve palsy. By decreasing the ability of the non-involved eye to elevate, a fixation duress was created which eliminated the secondary deviation that characteristically occurs in such patients when the involved eye fixates. As a result of this technique, both eyes in all patients on attempted fixation were under similar duress, therefore requiring equal amounts of stimulation to move into the primary position. When the fixation duress was sufficient, elimination of the hypotropia and ptosis was achieved. Additionally, in order to correct the exotropia, generous recession and resection procedures in the involved eye and recession of the lateral rectus in the noninvolved eye were performed. RESULTS: Between 8 and 10 prism dioptres of esotropia were achieved and maintained in two patients. One patient had 20 prism dioptres of exotropia. Two patients had no residual ptosis and one required an additional anterior levator resection to achieve a satisfactory result. CONCLUSION: Patients with a third nerve palsy and a pseudoptosis may be candidates for this approach.
Adolescent↗
Binocular fixation pattern and visual acuity in children with strabismic amblyopia.
BACKGROUND: A prospective study was undertaken to compare the binocular fixation pattern and presence of amblyopia in strabismic children. METHODS: Fifty-three children with manifest strabismus and the ability to cooperate with an optotype acuity test were examined. The binocular fixation pattern and logMAR visual acuity were recorded by separate, masked observers under standardized conditions. The binocular fixation pattern was divided into four grades from alternation to uniocular fixation. RESULTS: Patients who freely alternated did not have amblyopia, while those who maintained or preferred fixation with a given eye tended to have amblyopia in the nonpreferred eye. CONCLUSION: The binocular fixation pattern can be rapidly assessed with minimal equipment and training. These findings confirm the usefulness of a graded assessment of the binocular fixation pattern in the detection of amblyopia.
Adolescent↗