Biomedical subjects

G J Selvin

Publications and source records attributed to G J Selvin.

9 recordsLinked to original sources

PubMed1998

Weber's syndrome secondary to subarachnoid hemorrhage.

BACKGROUND: Since a large intracranial hemorrhage is a space-occupying mass, it may cause the brain to shift, resulting in neurologic deficits both at the location of the bleeding and at a site distal to the hemorrhage. A parietal lobe hemorrhage may push the brain downward, causing the uncus of the temporal lobe to herniate through the tentorial notch, compressing the midbrain. The signs of parietal lobe damage, uncal herniation, and several midbrain syndromes that effect ocular motility are discussed. CASE REPORT: A 66-year-old Hispanic man came to us with a history of a subarachnoid hemorrhage that involved the right parietal lobe. Several signs of damage to both the right parietal lobe and midbrain were evident, including an ipsilateral third nerve paresis with contralateral hemiplegia, Weber's syndrome. CONCLUSION: A patient who survives a subarachnoid hemorrhage may demonstrate permanent residual neurologic deficits subsequent to the acute event. The presentation is particularly complex when the hemorrhage is large and damage occurs at multiple locations. Damage at the level of the midbrain is evident when the findings include Weber's syndrome, which is one of several syndromes that involves the oculomotor nerve.

Aged↗

PubMed1994

Clinical pearls in optometric management of the geriatric patient.

BACKGROUND: Painstaking attention to detail is absolutely necessary for optometrists to provide the appropriate clinical management of the geriatric patient. METHODS: Clinical management techniques (pearls) are discussed which aid in the diagnosis and treatment of problems specific to geriatric patients. Factors noted in patient presentation are stressed and include physical appearance, ability to move about, and use of other senses. The most commonly occurring eye anomalies occurring in the geriatric population are discussed including iatrogenic drug side effects, pupillary anomalies, extraocular palsies, dry eye, corneal degenerations, refractive error changes, lenticular changes, glaucoma, age-related maculopathy, vitreoretinal disease, and ocular manifestations of systemic disease (vascular occlusive disease, diabetes, ischemic optic neuropathy, other neuro-ophthalmic disease). RESULTS: Conditions relatively rare in the young population occur with regularity in the elderly population and often must be assumed to be present in concert with some typical patient presentations in the geriatric population. CONCLUSIONS: Optometrists as primary health care providers often provide the only avenue individuals with blinding and sometimes life threatening conditions have in managing these conditions. Optometrists managing geriatric patients are required to know what happens to this population from an ocular disease as well as other function and dysfunction standpoint.

Aged↗

PubMed1993

Basal cell and squamous cell carcinomas.

Basal cell and squamous cell carcinomas are actinic lesions that must be considered in the differential diagnosis of growths of the eyelid. Basal cell carcinoma is the most common eyelid cancer. It tends to grow slowly, and rarely if ever metastasizes. Basal cell carcinoma can, however, grow by direct extension to adjacent structures including the brain. Basal cell carcinoma can be managed by Moh's surgery, excision, cryosurgery, radiation, and chemotherapy. Squamous cell carcinoma has similar epidemiology to basal cell carcinoma. However, it grows much faster and it can metastasize (up to 20% of the time). It is best managed by conventional surgery, cryosurgery, and sometimes radiation. Squamous cell carcinoma can have a grim prognosis if not detected and treated promptly.

Basal Cell Carcinoma↗

PubMed1991

Parietal and bi-occipital lobe infarction confounded by ethanol-induced optic neuropathy.

A frequent occurrence in geriatric and chronically ill patients is the exhibition of several simultaneously occurring and confounding health problems. This paper reports the case of a 61-year-old-white male who presented with an extensive history of multiple brain infarcts, hemiparesis, personality changes and varied visual complaints. Tests in the neurooptometric work-up for this patient included static automated perimetry, stereoacuity and optokinetic nystagmus evaluation. The results were suggestive of multiple cerebrovascular accidents which included the right and left occipital lobes as well as the right parietal lobe. This clinical picture was complicated by the presence of nutritional or ethanol-induced optic neuropathy. Emphasis was placed on a detailed sequential history of events and a complete neurological and optometric evaluation to ascertain the multiple foci of cortical infarction. Corroboration of clinical findings was obtained by computerized axial tomography (CT scan).

Alcoholism↗

PubMed1991

Localization of visual field defects in multiple sclerosis.

Demyelinating plaques can occur throughout the central nervous system in multiple sclerosis, possibly involving the visual pathways at any location. The proper evaluation of visual field defects in multiple sclerosis patients enables the optometrist to become a part of the health care team in monitoring the severity and progression of the disease. Three case reports are presented which illustrate the variable presentations and the proper interpretation of findings to localize demyelinating plaques in the visual pathways.

Adult↗

PubMed1991

Congenital optociliary shunt vessels.

Congenital optociliary shunt vessels have rarely been reported in the literature. Three cases of congenital optociliary shunt vessels are presented: two with unilateral shunt vessels and one with bilateral shunt vessels. All three patients were asymptomatic with good visual acuity and essentially normal visual fields with no apparent change in visual function over time. Associated with congenital optociliary shunt vessels is an anomalous bifurcation of the vasculature. Diagnostic implications of optociliary shunt vessels include 1) congenital variations, or 2) acquired secondary to a long-standing venous congestive event as occurs with optic nerve sheath meningioma, central retinal vein occlusion, papilledema, hyaloid bodies of the optic nervehead, dysthyroid optic neuropathy, and papillophlebitis.

Aged↗

PubMed1990

Corneal arcus as an indicator of hypercholesterolemia.

For many years, corneal arcus has been documented as a normal, age-related change. Recent literature implies that corneal arcus is associated with elevated cholesterol, especially in the young, but that the association is not apparent in the elderly. This study demonstrates corneal arcus, regardless of age, as an indicator of elevated serum cholesterol, and as such, a sign of increased risk for cardiovascular disease.

Adult↗

PubMed1989

Ocular effects of second generation oral hypoglycemic agents.

Second generation oral hypoglycemic agents, such as glyburide and glipizide, are often the treatment of choice in non-insulin dependent diabetes mellitus. These sulfonylureas are more potent osmotic agents than their predecessors and may give rise to crystalline lens changes and refractive error shifts in the absence of blood glucose variation. Such a case is presented, as is a detailed description of the mechanism of action of commonly prescribed oral hypoglycemic agents.

Administration, Oral↗

PubMed1987

Unilateral pigmented mobile vitreous cyst.

A patient presented with a pigmented mobile vitreous cyst in the right eye. The cyst was 6-7 mm in diameter, and was free-floating in the inferior half of the vitreous with no apparent attachments. No other ocular pathology was present in either eye. The patient became symptomatic only when the cyst obscured the visual axis. The literature was reviewed and will be discussed in this report.

Adult↗