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Biomedical subjects

E Y Yap

Publications and source records attributed to E Y Yap.

9 recordsLinked to original sources
PubMed1996

The long-term outcome of central serous chorioretinopathy.

OBJECTIVE: To assess the long-term outcome of central serous chorioretinopathy (CSR) among a group of patients who previously participated in a prospective argon laser photocoagulation study of CSR. DESIGN: Thirty-eight of 41 surviving patients with CSR participating in an earlier study were invited to participate in a follow-up study that included history taking, ophthalmoscopy, biomicroscopy, and fundus photography. RESULTS: Thirty-seven (38 eyes) of 38 surviving patients (97%) were available for follow-up between 11 and 15 years after participation in the earlier study. There were no clinically documented or historical recurrences of CSR among the six eyes previously treated by direct laser photocoagulation. There were 13 clinically documented recurrences and four historical recurrences among the 32 eyes not treated with direct laser photocoagulation. The difference in recurrences was statistically significant (P = .02). Pigment changes indistinguishable from age-related macular degeneration frequently occurred in eyes with CSR. The difference in the development of such pigment changes between eyes with CSR (33 of 38) and nonaffected fellow eyes (12 of 35) was significant (P = .001). CONCLUSIONS: The decreased rate of CSR recurrence after direct laser photocoagulation reported in an earlier study was sustained with follow-up beyond 10 years. Pigmentary changes in the fundus indistinguishable from those associated with age-related macular degeneration developed in eyes affected with CSR, probably as a consequence of the presence of subretinal fluid accompanying the CSR rather than from early age-related macular degeneration.

Choroid Diseases↗
PubMed1996

Oedipism.

BACKGROUND: Oedipism or self-enucleation is a rare form of self-mutilation, and most often described in acutely psychotic patients, who have religious or sexual delusions. CLINICAL RECORD: A 47-year-old Chinese man with a history of chronic schizophrenia enucleated his own left eye and mutilated his right eye. The reason for his behaviour was unknown. The history and legends surrounding autoenucleation and the medical literature are reviewed. RESULTS: The patient was managed jointly with the psychiatrist. He suffered extensive injury to his right eye, resulting in loss of vision. CONCLUSION: The management of Oedipism requires close cooperation between ophthalmologists and psychiatrists. Precautions must be taken to prevent repeated attempts or other self-mutilatory behaviour.

Eye Enucleation↗
PubMed1996

Spasmus nutans.

Spasmus nutans is classically described as a triad of nystagmus, head nodding and torticollis. It occurs in children, beginning in infancy and usually disappears in childhood. It is uncommon but its prompt recognition by ophthalmologists, paediatricians and neurologists can provide reassurance to the family of its benign nature. It is important to distinguish it from more serious conditions like gliomas which may present with signs mimicking spasmus nutans. We describe a case of a 3-year-old boy with acquired horizontal pendular nystagmus associated with head nodding and torticollis. The diagnosis of spasmus nutans, its implications and its management are discussed.

Child, Preschool↗
PubMed1993

A review of anaesthesia in ophthalmology.

In this article, we review the methods of anaesthesia commonly used in ophthalmology in Singapore. These include topical, local, regional and general anaesthesia. Topical and local anaesthesia is adequate for most outpatient procedures. The most common form of regional anaesthesia in Singapore is still retrobulbar anaesthesia. General anaesthesia is used in children and when more extensive procedures are performed.

Anesthesia↗
PubMed1992

Scleritis as an initial manifestation of choroidal malignant melanoma.

PURPOSE: The purpose of this article is to present the unusual circumstances in which malignant melanoma of the choroid can masquerade as scleritis, thus confounding its diagnosis. METHODS: Three cases of plaque-like malignant melanomas of the choroid are reported that, on initial examination, had features of scleritis. The events leading to their eventual correct diagnosis also are presented. RESULTS: In each case, there was ocular pain, blurred vision, anterior chamber and/or vitreous cavity cellular reaction, and an exudative retinal detachment associated with an ill-defined, relatively flat variably pigmented choroidal mass. In all three cases, the inflammatory component responded promptly to corticosteroid treatment and was accompanied by visual improvement. In two eyes, shrinkage of the choroidal mass accompanied the corticosteroid treatment, lending support to a working diagnosis of scleritis. By demonstrating expansion of the choroidal masses, examination of sequential fundus photographs influenced the decision to enucleate the eyes for presumed malignant choroidal melanoma. CONCLUSION: Clinicians should be alert to the circumstances in which malignant melanomas of the choroid can masquerade as scleritis. Careful evaluation by ophthalmoscopy, ultrasonography, fundus photography, and subsequent sequential examination is necessary to arrive at the correct diagnosis.

Adult↗
PubMed1992

Visual loss associated with pseudoxanthoma elasticum.

An 18-year-old woman with pseudoxanthoma elasticum had sudden profound bilateral visual loss, presumably as a result of optic nerve infarction caused by anemia and hypotension from massive gastrointestinal bleeding. Her central visual acuity largely recovered in her right eye, but her left eye had only hand motions acuity. During the subsequent 24 years, she underwent three separate surgical procedures for gastrointestinal bleeding. Abdominal arterial angiography showed numerous aneurysms of the gastric arteries. A subtotal gastrectomy was done, and histopathologic examination found advanced degenerative changes of the elastic lamina of the gastric arteries. At age 42 years, the patient lost residual vision in her right eye. This was caused by an extrafoveal subretinal choroidal neovascular membrane, which was obliterated with laser photocoagulation. Degeneration of elastic tissue, the primary defect in this syndrome, may cause cardiovascular complications and formation of breaks in the Bruch membrane, which are visible as angioid streaks. Ingrowth of fibrovascular tissue through angioid streaks may cause disturbances of macular function. The optic nerve ischemia and infarction associated with the profound visual loss in this patient reminds the ophthalmologist of the systemic nature of this disorder and the possibility that systemic vascular complications with massive blood loss may occur.

Adolescent↗
PubMedDate not supplied

Pupil abnormalities on the first postoperative day after cataract surgery.

Most, if not all, ophthalmologists strive to achieve a round pupil after cataract surgery with posterior chamber lens implantation. The presence of pupil abnormalities and iris modifications is cosmetically undesirable and may affect the quality of postoperative vision. The pupillary motility may be changed which will in turn affect both pupillary light reflexes and pupillary dilatation during fundus examination. In this paper, we prospectively studied 2 groups of patients who underwent uncomplicated cataract surgery with posterior chamber lens implantation; 100 patients who had planned extracapsular cataract extraction (ECCE), and 130 patients who underwent phacoemulsification. On the first postoperative day, we found a 16% rate of pupil abnormalities in the group which underwent ECCE surgery while only 5.3% of the phacoemulsification group had pupil abnormalities. There were different causes in which the two groups. The most common cause of pupil abnormality after ECCE was due to iris sphincter rupture, whereas the most common cause after phacoemulsification was due to iris trauma during phacoemulsification. These pupil abnormalities are the direct consequence of factors in surgery and we suggest ways to minimize the occurrence of such abnormalities in cataract surgery.

Cataract Extraction↗