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Biomedical subjects

G W Aylward

Publications and source records attributed to G W Aylward.

16 recordsLinked to original sources
PubMed1992

A scoring method for Hess charts.

A new scoring system for Hess charts is described. Scores for both horizontal and vertical deviations are calculated from the displacement of individual points on the Hess chart, using weighting factors for the centre, inner and outer zones. The scoring system was validated in a group of 24 patients undergoing surgery for paralytic or restrictive strabismus. Subjective scores were obtained from patients both before and after corrective surgery, and corresponding Hess charts were scored using the new system. There was a good correlation between the changes in subjective and objective score. Our scoring system has applications in both research and clinical practice, allowing objective analysis of changes in muscle balance in a variety of motility disorders.

Diplopia↗
PubMed1992

Actinomycosis of the orbit.

Actinomycosis is a very rare cause of orbital abscess usually attributable to direct spread from adjacent structures. A case of actinomycosis of the orbit is presented, which was treated as orbital pseudotumour for 3 months before progression of signs and symptoms, despite high dose steroids, led to the diagnosis being reconsidered.

Actinomycosis↗
PubMed1991

Ocutome lensectomy: results and complications.

We describe the results and the complications encountered in 69 lensectomies performed via a limbal approach with the Ocutome vitrectomy instrument, in which it was the intention at surgery to maintain the integrity of the posterior capsule. After operation 87% improved in visual acuity, and 68% achieved 6/12 or better. The main early complications encountered were perioperative rupture of the posterior capsule and iris damage. The main late complications were postoperative thickening of the posterior capsule, retinal detachment, and bullous keratopathy. Of the eyes in which the posterior capsule remained intact after operation 17% developed thickening of the posterior capsule to a degree that required capsulotomy over a mean follow-up period of 50 months.

Adolescent↗
PubMed1990

The conservative management of choroidal melanoma.

The results of 32 choroidal melanomas managed by observation, Iodine-125 scleral plaques and local surgical excision are presented. Initially, 12 patients were managed by observation, and of these three continued to be managed by observation alone. Fifteen patients were managed with Iodine-125 scleral plaques and followed for an average of 15 months. The tumour regressed in 11, remained the same in three, and recurred in one case. The final visual acuity remained within two Snellen lines of that recorded preoperatively in 10 patients. Fourteen patients underwent local excision with an average follow-up of 31 months. These cases, in general, had larger tumours. The final visual acuity was within two Snellen lines of the preoperative vision in four patients. Five eyes required enucleation at a later date. Four of the five enucleations occurred earlier in the series. The management of choroidal melanoma remains controversial. Various methods of conservative treatment are described and the indications for conservative management by observation, scleral plaque and local excision are discussed.

Adult↗
PubMed1989

The wide-angle pattern electroretinogram. Relation between pattern electroretinogram amplitude and stimulus area using large stimuli.

Pattern electroretinograms (PERGs) were recorded from two normal human subjects in response to various spatial frequencies and stimulus areas. The maximum stimulus area was 75 degrees x 86 degrees which was achieved by using a standard TV monitor and a reduced viewing distance. The amplitude of the PERG increased with area in an approximately logarithmic fashion over the range investigated. The explanation relates to non-linearities of the stimulus, the retinal image and neural processing. The wide-angle PERG may be useful in the assessment of retinal diseases affecting the mid-peripheral inner retina, such as diabetic retinopathy.

Electroretinography↗
PubMed1989

The effect of gold foil electrode position on the electroretinogram in human subjects.

Photopic ERGs were recorded in two human subjects using gold foil electrodes mounted at various positions in the lower fornix. The peak to peak amplitude of the b-wave was reduced in both subjects when the centre of the electrode was placed beyond 15 mm from the medial side of the limbus. The implicit time of the a-wave and the b-wave was not dependent on electrode position. These results emphasize the importance of correct placement of gold foil electrodes.

Electrodes↗
PubMed1989

The scotopic threshold response in diabetic retinopathy.

The scotopic threshold response (STR) is a recently discovered component of the electroretinogram. It is a corneal negative deflection elicited in the fully dark adapted eye to dim stimuli, and appears to originate in the inner retina. The STR was recorded in a group of 50 insulin dependent diabetics with various degrees of diabetic retinopathy, who had not undergone laser photocoagulation. In addition, the scotopic b-wave, oscillatory potentials (OPs) and a pattern electroretinogram (PERG) were recorded. Retinopathy was assessed with stereo colour photographs of the seven standard fields as defined in the Diabetic Retinopathy Study. Retinopathy level was assigned to each eye using a modification of the Airlie House Classification System. Fluorescein angiograms were taken using a 60 degree fundus camera and graded for the presence of leakage and capillary non-perfusion. There was a significant correlation between the severity of retinopathy and the amplitude and latency of the STR. There was a similar correlation with the amplitude and latency of the OPs, a weaker correlation with the amplitude of the PERG, but no significant correlation with the latency of the PERG. These results support an inner retinal origin for the STR and suggest a role for STR in the electroretinographic assessment of diabetic retinopathy.

Adolescent↗
PubMed1989

Atypical mycobacterial keratitis.

A case of marginal corneal abscess and hypopyon due to Mycobacterium chelonae is presented. Its therapy is described, followed by a brief discussion of atypical mycobacterial keratitis.

Abscess↗
PubMed1989

The scotopic threshold response in diabetic retinopathy--a preliminary report.

The scotopic threshold response (STR) and the scotopic b-wave of the electroretinogram were recorded in a group of 30 patients with insulin-dependent diabetes mellitus. Retinopathy was assessed using colour stereo fundus photography and an adaptation of the Airlie House classification scheme. Wide-angle fundus fluorescein angiography was also performed and angiograms were graded for the presence of leakage and capillary non-perfusion. The STR was reduced in those eyes with retinopathy of grade 3 or above compared with eyes with retinopathy of grade 2 or below. There was a significant correlation between the amplitude of the STR and: (1) the grade of retinopathy; and (2) fluorescein leakage. There was no correlation between the b-wave amplitude and the severity of retinopathy. The STR may have a role as a screening test for diabetic retinopathy.

Adult↗
PubMed1989

Repair of an avulsed upper lid and partially severed lower lid.

We present a case in which trauma from a broken glass resulted in complete amputation of the upper lid and severe lacerations to the lower lid but with an intact and functioning globe. The avulsed upper lid was repaired as a composite autograft. The possible management of such an unusual case is discussed.

Amputation, Traumatic↗
PubMed1989

Transient corneal changes associated with the use of gold foil electrodes.

The corneas of 50 normal subjects were examined before and after electroretinography performed with gold foil electrodes. Examination included slit-lamp biomicroscopy and staining with sodium fluorescein. All corneas were normal on examination prior to electroretinography. Three types of transient corneal changes were observed--punctate epithelial keratitis, corneal erosions, and stromal thinning. Each cornea was assigned a numerical damage score based on a simple scoring system. Thirty one subjects (62%) had some degree of corneal change, and in three cases (6%) follow-up was required. Multiple regression analysis was performed to discover any risk factors. Both age of the subject and the use of local anaesthetic were strongly associated with corneal changes.

Adult↗
PubMed1989

Extensive argon laser photocoagulation in the treatment of proliferative diabetic retinopathy.

A group of 20 patients (28 eyes) with proliferative retinopathy who required extensive argon laser photocoagulation to induce regression of new vessels is presented. The mean number of burns applied to each eye was 7225, with a maximum of 11,513. These were delivered in a mean of nine sessions over a mean period of 22.9 months. Twenty-five eyes (89%) had a final visual acuity of 6/18 or better. The remaining three eyes (11%) had severely reduced vision attributable to complications of proliferative diabetic retinopathy (traction retinal detachment involving the macula in two eyes and ischaemic maculopathy and a persistent vitreous haemorrhage in the third). Large amounts of confluent argon laser photocoagulation may be necessary for the elimination of new vessels in some patients, and it is our view that laser photocoagulation should be continued until regression of new vessels occurs. This is compatible with the retention of functional vision and good visual acuity.

Adult↗
PubMed1989

'In-the-bag' hyphaema--a rare complication of posterior chamber lens implantation.

A 72-year-old woman developed a hyphaema on the first postoperative day after a combined trabeculectomy and extracapsular cataract extraction with posterior chamber intraocular lens implantation. On the second day the blood had redistributed to accumulate 'in the bag' posterior to the intraocular lens and had formed a fluid level. Postural drainage helped to clear the hyphaema from both locations, with no short-term effect on visual function or the filtering bleb.

Aged↗
PubMedDate not supplied

The surgical treatment of traumatic Brown syndrome.

We present the results of surgical treatment in 13 patients who attended Moorfields Eye Hospital with traumatic Brown syndrome between 1975 and 1990. The average age was 34 years (range, 18 to 46 years), and in 12 cases the cause was a road traffic accident. Diplopia was the indication for surgery in all cases. Most patients had two surgical procedures; but in two patients, three were required. The outcome was assessed both subjectively and objectively. Objective assessment was by analysis of the preoperative and postoperative fields of binocular single vision and Hess charts which were available for 11 patients. The Hess charts were analyzed using a new scoring system. At final follow up, subjective improvement had occurred in 7 patients, 3 patients reported no improvement, and 3 patients thought their symptoms were worse. The field of binocular single vision improved in 8 patients and was worse in 3 patients. The Hess chart improved in 8 patients and was worse in 3 patients. The management of this difficult condition is discussed.

Adolescent↗