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Biomedical subjects

E Wortham

Publications and source records attributed to E Wortham.

10 recordsLinked to original sources

Effect of varying drop size on the efficacy and safety of a topical beta blocker.

We studied the effects on efficacy and safety of varying the drop size of a topical solution of levobunolol 0.5%. In a double-masked, crossover acute study, we administered a single drop of either 35 microL of vehicle, or 20, 35, or 50 microL of levobunolol one hour before the subjects began a ten-minute treadmill challenge electrocardiogram. After exercise the mean heart rate was 111 beats per minute (bpm) in the vehicle group and 102 to 103 bpm in the three levobunolol groups, which were significantly different from the control group but not from each other. In a randomized double-masked, parallel, chronic study, 117 patients with elevated intraocular pressure (IOP) instilled one of the three drop sizes of levobunolol twice daily for three months. Mean decreases in IOP ranged from 5.1 to 6.0 mmHg in the three groups, not significantly different from each other in mean IOP, heart rate, or blood pressure. We conclude that drop size in the range tested had no clinically significant effect on either efficacy or safety of a beta blocker such as levobunolol.

Administration, Topical↗

Expanded binocular peripheral visual fields following surgery for esotropia.

We measured the horizontal extent of the binocular peripheral field of vision in ten adult esotropes using Goldmann perimetry before and after strabismus surgery. In every case there was expansion of the field by an amount approximately commensurate with the change in angle of strabismic deviation. This occurred regardless of the presence of amblyopia or recovery of binocular fusion. Subjective improvement in peripheral vision was appreciated by a number of patients. Visual field expansion should be recognized as a significant indication for correction of esotropia.

Adult↗

Botulinum A toxin treatment of a deviated orbital implant.

We report a case of progressive deviation of an implant that resulted in conjunctival thinning and an inadequately fit prosthesis. Such a case may have been treated with conjunctival grafting or replacement of the implant with an hydroxyapatite sphere. In this case, injection of botulinum A toxin (Botox) into the contracted medial rectus muscle contributed to the successful refitting of a new and stable prosthesis and improvement of the conjunctival integrity. Possible explanations of the progressive shift in the position of the implant and its postinjection stability are discussed.

Adult↗